Neuroethics
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philosophy Philosophy (from , ) is the systematized study of general and fundamental questions, such as those about existence, reason, knowledge, values, mind, and language. Such questions are often posed as problems to be studied or resolved. ...
and
neuroscience Neuroscience is the science, scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, an ...
, Neuroethics is the study of both the ethics of neuroscience and the neuroscience of ethics. The ethics of neuroscience comprises the bulk of work in neuroethics. It concerns the ethical, legal and social impact of neuroscience, including the ways in which
neurotechnology Neurotechnology encompasses any method or electronic device which interfaces with the nervous system to monitor or modulate neural activity. Common design goals for neurotechnologies include using neural activity readings to control external devi ...
can be used to predict or alter human behavior and "the implications of our mechanistic understanding of brain function for society... integrating neuroscientific knowledge with ethical and social thought". Some neuroethics problems are not fundamentally different from those encountered in
bioethics Bioethics is both a field of study and professional practice, interested in ethical issues related to health (primarily focused on the human, but also increasingly includes animal ethics), including those emerging from advances in biology, me ...
. Others are unique to neuroethics because the brain, as the organ of the mind, has implications for broader philosophical problems, such as the nature of
free will Free will is the capacity of agents to choose between different possible courses of action unimpeded. Free will is closely linked to the concepts of moral responsibility, praise, culpability, sin, and other judgements which apply only to ac ...
,
moral responsibility In philosophy, moral responsibility is the status of morally deserving praise, blame, reward, or punishment for an act or omission in accordance with one's moral obligations. Deciding what (if anything) counts as "morally obligatory" is a pr ...
,
self-deception Self-deception is a process of denying or rationalizing away the relevance, significance, or importance of opposing evidence and logical argument. Self-deception involves convincing oneself of a truth (or lack of truth) so that one does not rev ...
, and
personal identity Personal identity is the unique numerical identity of a person over time. Discussions regarding personal identity typically aim to determine the necessary and sufficient conditions under which a person at one time and a person at another time ca ...
. Examples of neuroethics topics are given later in this article . The origin of the term "neuroethics" has occupied some writers. Rees and Rose (as cited in "References" on page 9) claim ''neuroethics'' is a
neologism A neologism Ancient_Greek.html"_;"title="_from_Ancient_Greek">Greek_νέο-_''néo''(="new")_and_λόγος_/''lógos''_meaning_"speech,_utterance"is_a_relatively_recent_or_isolated_term,_word,_or_phrase_that_may_be_in_the_process_of_entering_com ...
that emerged only at the beginning of the 21st century, largely through the
oral The word oral may refer to: Relating to the mouth * Relating to the mouth, the first portion of the alimentary canal that primarily receives food and liquid ** Oral administration of medicines ** Oral examination (also known as an oral exam or or ...
and written
communication Communication (from la, communicare, meaning "to share" or "to be in relation with") is usually defined as the transmission of information. The term may also refer to the message communicated through such transmissions or the field of inqui ...
s of
ethicist An ethicist is one whose judgment on ethics and ethical codes has come to be trusted by a specific community, and (importantly) is expressed in some way that makes it possible for others to mimic or approximate that judgment. Following the advice of ...
s and
philosopher A philosopher is a person who practices or investigates philosophy. The term ''philosopher'' comes from the grc, φιλόσοφος, , translit=philosophos, meaning 'lover of wisdom'. The coining of the term has been attributed to the Greek th ...
s. According to Racine (2010), the term was coined by the Harvard physician Anneliese A. Pontius in 1973 in a paper entitled "Neuro-ethics of 'walking' in the newborn" for the ''Perceptual and Motor Skills''. The author reproposed the term in 1993 in her paper for ''Psychological Report'', often wrongly mentioned as the first title containing the word "neuroethics". Before 1993, the American neurologist
Ronald Cranford Ronald Eugene Cranford (1941 – May 31, 2006) was a neurologist and expert on comas and unconsciousness. He is best known for his work with families on public cases involving persons in a persistent vegetative state. He and three other docto ...
has used the term (see Cranford 1989). Illes (2003) records uses, from the scientific literature, from 1989 and 1991. Writer
William Safire William Lewis Safire (; Safir; December 17, 1929 – September 27, 2009Safire, William (1986). ''Take My Word for It: More on Language.'' Times Books. . p. 185.) was an American author, columnist, journalist, and presidential speechwriter. He ...
is widely credited with giving the word its current meaning in 2002, defining it as "the examination of what is right and wrong, good and bad about the treatment of, perfection of, or unwelcome invasion of and worrisome manipulation of the human brain".


Two categories of problems

Neuroethics encompasses the myriad ways in which developments in basic and clinical neuroscience intersect with social and ethical issues. The field is so young that any attempt to define its scope and limits now will undoubtedly be proved wrong in the future, as
neuroscience Neuroscience is the science, scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, an ...
develops and its implications continue to be revealed. At present, however, we can discern two general categories of neuroethical issue: those emerging from what we can do and those emerging from what we know. In the first category are the ethical problems raised by advances in functional
neuroimaging Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Incr ...
,
psychopharmacology Psychopharmacology (from Greek grc, ψῡχή, psȳkhē, breath, life, soul, label=none; grc, φάρμακον, pharmakon, drug, label=none; and grc, -λογία, -logia, label=none) is the scientific study of the effects drugs have on mo ...
, brain implants and brain-machine interfaces. In the second category are the ethical problems raised by our growing understanding of the neural bases of behavior, personality, consciousness, and states of spiritual transcendence.


Historical background and implications of neuroscience ethics

Primitive societies for the most part lacked a system of neuroethics to guide them in facing the problems of mental illness and violence as civilization advanced.
Trepanation Trepanning, also known as trepanation, trephination, trephining or making a burr hole (the verb ''trepan'' derives from Old French from Medieval Latin from Greek , literally "borer, auger"), is a surgical intervention in which a hole is dri ...
led through a tortuous course to "
psychosurgery Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under t ...
". Basic
neuroscience Neuroscience is the science, scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, an ...
research and psychosurgery advanced in the first half of the 20th century in tandem, but neuroscience ethics was left behind science and technology.
Medical ethics Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. T ...
in modern societies even in democratic governments, not to mention in
authoritarian Authoritarianism is a political system characterized by the rejection of political plurality, the use of strong central power to preserve the political ''status quo'', and reductions in the rule of law, separation of powers, and democratic vot ...
ones, has not kept pace with the advances of
technology Technology is the application of knowledge to reach practical goals in a specifiable and reproducible way. The word ''technology'' may also mean the product of such an endeavor. The use of technology is widely prevalent in medicine, scien ...
despite the announced social "progress"; and ethics continues to lag behind
science Science is a systematic endeavor that builds and organizes knowledge in the form of testable explanations and predictions about the universe. Science may be as old as the human species, and some of the earliest archeological evidence ...
in dealing with the problem of
mental illness A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitt ...
in association with human
violence Violence is the use of physical force so as to injure, abuse, damage, or destroy. Other definitions are also used, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened ...
. Unprovoked "pathological" aggression persists, reminding us daily that civilization is a step away from relapsing into barbarism. Neuroscience ethics (neuroethics) must keep up with advances in neuroscience research and remain separate from state-imposed mandates to face this challenge. A recent writer on the history of psychosurgery as it relates to neuroethics concludes: "The lessons of history sagaciously reveal wherever the government has sought to alter medical ethics and enforce bureaucratic bioethics, the results have frequently vilified medical care and research. In the 20th century in both the communist
USSR The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, it was nominally a federal union of fifteen nati ...
and
Nazi Germany Nazi Germany (lit. "National Socialist State"), ' (lit. "Nazi State") for short; also ' (lit. "National Socialist Germany") (officially known as the German Reich from 1933 until 1943, and the Greater German Reich from 1943 to 1945) was ...
, medicine regressed after these authoritarian systems corrupted the ethics of the medical profession and forced it to descend to unprecedented barbarism. The Soviet psychiatrists and Nazi doctor's dark descent into barbarism was a product of
physicians A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
willingly cooperating with the
totalitarian state Totalitarianism is a form of government and a political system that prohibits all opposition parties, outlaws individual and group opposition to the state and its claims, and exercises an extremely high if not complete degree of control and regul ...
, purportedly in the name of the " collective good", at the expense of their individual patients." This must be kept in mind when establishing new guidelines in neuroscience research and bioethics.


Important activity since 2002

There is no doubt that people were thinking and writing about the ethical implications of
neuroscience Neuroscience is the science, scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, an ...
for many years before the field adopted the label "neuroethics", and some of this work remains of great relevance and value. However, the early 21st century saw a tremendous surge in interest concerning the ethics of
neuroscience Neuroscience is the science, scientific study of the nervous system (the brain, spinal cord, and peripheral nervous system), its functions and disorders. It is a Multidisciplinary approach, multidisciplinary science that combines physiology, an ...
, as evidenced by numerous meetings, publications, and organizations dedicated to this topic. In 2002, there were several meetings that drew together neuroscientists and ethicists to discuss neuroethics: the
American Association for the Advancement of Science The American Association for the Advancement of Science (AAAS) is an American international non-profit organization with the stated goals of promoting cooperation among scientists, defending scientific freedom, encouraging scientific respons ...
with the journal ''
Neuron A neuron, neurone, or nerve cell is an electrically excitable cell that communicates with other cells via specialized connections called synapses. The neuron is the main component of nervous tissue in all animals except sponges and placozoa ...
'', the
University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a Private university, private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest- ...
, the
Royal Society The Royal Society, formally The Royal Society of London for Improving Natural Knowledge, is a learned society and the United Kingdom's national academy of sciences. The society fulfils a number of roles: promoting science and its benefits, re ...
,
Stanford University Stanford University, officially Leland Stanford Junior University, is a private research university in Stanford, California. The campus occupies , among the largest in the United States, and enrolls over 17,000 students. Stanford is conside ...
, and the Dana Foundation. This last meeting was the largest, and resulted in a book, ''Neuroethics: Mapping the Field'', edited by Steven J. Marcus and published by Dana Press. That same year, the ''Economist'' ran a cover story entitled "Open Your Mind: The Ethics of Brain Science", ''
Nature Nature, in the broadest sense, is the physical world or universe. "Nature" can refer to the phenomena of the physical world, and also to life in general. The study of nature is a large, if not the only, part of science. Although humans are ...
'' published the article "Emerging ethical issues in neuroscience". Further articles appeared on neuroethics in ''
Nature Neuroscience ''Nature Neuroscience'' is a monthly scientific journal published by Nature Publishing Group. Its focus is original research papers relating specifically to neuroscience and was established in May 1998. The chief editor is Shari Wiseman. According ...
'', ''Neuron'', and ''
Brain and Cognition ''Brain and Cognition'' is an American scientific journal founded in 1982. It covers the fields of cognitive neuroscience and psychophysiology. According to the '' Journal Citation Reports'', the journal has a 2016 impact factor The impact fa ...
''. Thereafter, the number of neuroethics meetings, symposia, and publications continued to grow. The over 38 000 members of the
Society for Neuroscience The Society for Neuroscience (SfN) is a professional society, headquartered in Washington, DC, for basic scientists and physicians around the world whose research is focused on the study of the brain and nervous system. It is especially well kn ...
recognized the importance of neuroethics by inaugurating an annual "special lecture" on the topic, first given by Donald Kennedy, editor-in-chief of Science Magazine. Several overlapping networks of scientists and scholars began to coalesce around neuroethics-related projects and themes. For example, the American Society for Bioethics and Humanities established a Neuroethics Affinity Group, students at the
London School of Economics , mottoeng = To understand the causes of things , established = , type = Public research university , endowment = £240.8 million (2021) , budget = £391.1 milli ...
established the Neuroscience and Society Network linking scholars from several different institutions, and a group of scientists and funders from around the world began discussing ways to support international collaboration in neuroethics through what came to be called the International Neuroethics Network. Stanford began publishing the monthly Stanford Neuroethics Newsletter, Penn developed the informational website neuroethics.upenn.edu, and the Neuroethics and Law Blog was launched. Several relevant books were published during this time as well: Sandra Ackerman's ''Hard Science, Hard Choices: Facts, Ethics and Policies Guiding Brain Science Today'' (Dana Press),
Michael Gazzaniga Michael S. Gazzaniga (born December 12, 1939) is a professor of psychology at the University of California, Santa Barbara in the USA, where he heads the new SAGE Center for the Study of the Mind. He is one of the leading researchers in cognitiv ...
's ''The Ethical Brain'' (Dana Press), Judy Illes' edited volume, ''Neuroethics: Defining the Issues in Theory, Practice and Policy'' (both Oxford University Press),
Dai Rees David James Rees, (31 March 1913 – 15 November 1983) was one of the Britain's leading golfers either side of the Second World War. The winner of many prestigious tournaments in Britain, Europe and farther afield, Rees is best remembered as ...
and Steven Rose's edited volume ''The New Brain Sciences: Perils and Prospects'' (Cambridge University Press) and Steven Rose's ''The Future of the Brain'' (Oxford University Press). 2006 marked the founding of the International Neuroethics Society (INS) (originally the Neuroethics Society), an international group of scholars, scientists, clinicians, and other professionals who share an interest in the social, legal, ethical and policy implications of advances in neuroscience. The mission of the International Neuroethics Society "is to promote the development and responsible application of neuroscience through interdisciplinary and international research, education, outreach and public engagement for the benefit of people of all nations, ethnicities, and cultures". The first President of the INS was Steven Hyman (2006–2014), succeeded by Barbara Sahakian (2014–2016). Judy Illes is the current President, who like Hyman and Sahakian, was also a pioneer in the field of neuroethics and a founder member of the INS. Over the next several years many centers for neurotics were established. A 2014 review of the field lists 31 centers and programs around the world; some of the longest-running include the Neuroethics Research Unit at the Institut de recherches cliniques de Montreal (IRCM), the National Core for Neuroethics at the University of British Columbia in 2007, th
Center for Neurotechnology Studies
of the
Potomac Institute for Policy Studies The Potomac Institute for Policy Studies is an independent, 501(c)(3), not-for-profit public policy research institute located in Arlington, Virginia. The institute was founded in , shortly after the Congressional Office of Technology Assessment ...
, the Wellcome Centre for Neuroethics at the
University of Oxford , mottoeng = The Lord is my light , established = , endowment = £6.1 billion (including colleges) (2019) , budget = £2.145 billion (2019–20) , chancellor ...
; and th
Center for Neuroscience & Society
at the
University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a Private university, private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest- ...
. Since 2017, neuroethics working groups across multiple organizations have published a spate of reports and guiding principles. In 2017, th
Global Neuroethics Summit
Delegates prepared a set of ethical questions to guide research in brain science, published in Neuron. In December 2018, The Neuroethics Working Group of the National Institutes of Health (NIH) Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative proposed incorporating Neuroethics Guiding Principles into the research advanced by the Initiative. In December 2019, the Organisation for Economic Co-operation and Development (OECD) confirmed a set of neuroethics principles and recommendations; now this interdisciplinary group is developing a toolkit for implementation, moving from the theoretical to the practical. In early 2020, the Institute of Electrical and Electronics Engineers (IEEE) developed a neuroethical framework to facilitate the development of guidelines for engineers working on new neurotechnologies.


Sources of information

The books, articles and websites mentioned above are by no means a complete list of good neuroethics information sources. For example, readings and websites that focus on specific aspects of neuroethics, such as brain imaging or enhancement, are not included. Nor are more recent sources, such as Walter Glannon's book ''Bioethics and the Brain'' (Oxford University Press) and his reader, entitled Defining Right and Wrong in Brain Science (Dana Press). We should also here mention a book that was in many ways ahead of its time, Robert Blank's Brain Policy (published in 1999 by Georgetown University Press). The scholarly literature on neuroethics has grown so quickly that one cannot easily list all of the worthwhile articles, and several journals are now soliciting neuroethics submissions for publication, including the ''American Journal of Bioethics – Neuroscience'', ''BioSocieties'', the ''Journal of Cognitive Neuroscience'', and ''Neuroethics''. The web now has many sites, blogs, and portals offering information about neuroethics. A list can be found at the end of this entry.


Key issues

Neuroethics encompasses a wide range of issues, which can only be sampled here. Some have close ties to traditional biomedical ethics, in that different versions of these issues can arise in connection with organ systems other than the brain. For example, how should incidental findings be handled when a presumed healthy research subject is scanned for neuroscience research and the scan reveals an abnormality? How safe are the drugs used to enhance normal brain function? These are neuroethical issues with clear precedents in traditional bioethics. They are important issues, and luckily we can call upon society's experience with the relevant precedents to help determine the best courses of action in the present cases. In contrast, many neuroethical issues are at least partly novel, and this accounts for some of the intellectual fascination of neuroethics. These relatively newer issues force us to think about the relation between mind and brain and its ethical implications.


Brain interventions

The ethics of neurocognitive enhancement, that is the use of drugs and other brain interventions to make normal people "better than well", is an example of a neuroethical issue with both familiar and novel aspects. On the one hand, we can be informed by previous bioethical work on physical enhancements such as doping for strength in sports and the use of human growth hormone for normal boys of short stature. On the other hand, there are also some arguably novel ethical issues that arise in connection with brain enhancement, because these enhancements affect how people think and feel, thus raising the relatively new issues of " cognitive liberty". The growing role of
psychopharmacology Psychopharmacology (from Greek grc, ψῡχή, psȳkhē, breath, life, soul, label=none; grc, φάρμακον, pharmakon, drug, label=none; and grc, -λογία, -logia, label=none) is the scientific study of the effects drugs have on mo ...
in everyday life raises a number of ethical issues, for example the influence of drug marketing on our conceptions of mental health and normalcy, and the increasingly malleable sense of
personal identity Personal identity is the unique numerical identity of a person over time. Discussions regarding personal identity typically aim to determine the necessary and sufficient conditions under which a person at one time and a person at another time ca ...
that results from what Peter D. Kramer called "cosmetic psychopharmacology". Nonpharmacologic methods of altering brain function are currently enjoying a period of rapid development, with a resurgence of
psychosurgery Psychosurgery, also called neurosurgery for mental disorder (NMD), is the neurosurgical treatment of mental disorder. Psychosurgery has always been a controversial medical field. The modern history of psychosurgery begins in the 1880s under t ...
for the treatment of medication refractory mental illnesses and promising new therapies for neurological and psychiatric illnesses based on
deep brain stimulation Deep brain stimulation (DBS) is a neurosurgical procedure involving the placement of a medical device called a neurostimulator, which sends electrical impulses, through implanted electrodes, to specific targets in the brain (the brain nucleus ...
as well as relatively noninvasive transcranial stimulation methods. Research on brain-machine interfaces is primarily in a preclinical phase but promises to enable thought-based control of computers and robots by paralyzed patients. As the tragic history of
frontal lobotomy A lobotomy, or leucotomy, is a form of neurosurgical treatment for psychiatric disorder or neurological disorder (e.g. epilepsy) that involves severing connections in the brain's prefrontal cortex. The surgery causes most of the connection ...
reminds us, permanent alteration of the brain cannot be undertaken lightly. Although nonpharmacologic brain interventions are exclusively aimed at therapeutic goals, the US military sponsors research in this general area (and more specifically in the use of transcranial direct current stimulation) that is presumably aimed at enhancing the capabilities of soldiers.


Brain imaging

In addition to the important issues of safety and incidental findings, mentioned above, some arise from the unprecedented and rapidly developing ability to correlate brain activation with psychological states and traits. One of the most widely discussed new applications of imaging is based on correlations between brain activity and intentional deception. Intentional deception can be thought of in the context of a
lie detector A polygraph, often incorrectly referred to as a lie detector test, is a device or procedure that measures and records several physiological indicators such as blood pressure, pulse, respiration, and skin conductivity while a person is asked an ...
. This means that scientists use brain imaging to look at certain parts of the brain during moments when a person is being deceptive. A number of different research groups have identified
fMRI Functional magnetic resonance imaging or functional MRI (fMRI) measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area ...
correlates of intentional deception in laboratory tasks, and despite the skepticism of many experts, the technique has already been commercialized. A more feasible application of brain imaging is " neuromarketing", whereby people's conscious or unconscious reaction to certain products can purportedly be measured. Researchers are also finding brain imaging correlates of myriad psychological traits, including personality, intelligence, mental health vulnerabilities, attitudes toward particular ethnic groups, and predilection for violent crime. Unconscious racial attitudes may be manifest in brain activation. These capabilities of brain imaging, actual and potential, raise a number of ethical issues. The most obvious concern involves
privacy Privacy (, ) is the ability of an individual or group to seclude themselves or information about themselves, and thereby express themselves selectively. The domain of privacy partially overlaps with security, which can include the concepts of ...
. For example, employers, marketers, and the government all have a strong interest in knowing the abilities, personality, truthfulness and other mental contents of certain people. This raises the question of whether, when, and how to ensure the privacy of our own minds. Another ethical problem is that brain scans are often viewed as more accurate and objective than in fact they are. Many layers of signal processing, statistical analysis and interpretation separate imaged brain activity from the psychological traits and states inferred from it. There is a danger that the public (including judges and juries, employers, insurers, etc.) will ignore these complexities and treat brain images as a kind of indisputable truth. A related misconception is called neuro-realism: In its simplest form, this line of thought says that something is real because it can be measured with electronic equipment. A person who claims to have pain, or low libido, or unpleasant emotions is "really" sick if these symptoms are supported by a brain scan, and healthy or normal if correlates cannot be found in a brain scan. The case of
phantom limb A phantom limb is the sensation that an amputated or missing limb is still attached. Approximately 80 to 100% of individuals with an amputation experience sensations in their amputated limb. However, only a small percentage will experience pain ...
s demonstrate the inadequacy of this approach.


Memory dampening

While complete memory erasure is still an element of science-fiction, certain neurological drugs have been proven to dampen the strength and emotional association of a memory. Propranolol, an FDA-approved drug, has been suggested to effectively dull the painful effects of traumatic memories if taken within 6 hours after the event occurs. This has begun the discussion of ethical implications, assuming the technology for memory erasure will only improve. Originally, propranolol was reserved for hypertension patients. However, doctors are permitted to use the drug for off-label purposes—leading to the question of whether they actually ''should''. There are numerous reasons for skepticism; for one, it may prevent us from coming to terms with traumatic experiences, it may tamper with our identities and lead us to an artificial sense of happiness, demean the genuineness of human life, and/or encourage some to forget memories they are morally obligated to keep. Whether or not it is ethical to fully or partially erase the memory of a patient, it is certainly becoming a more relevant topic as this technology improves in our society.


Ethics of brain organoids


Sentient organoids


Guidelines and legislation


Humanized animals


Ethics of cognitive wetware


Cognitive diversity

In general, cognitive diversity – or some "optimum range of diversity" – was found highly valuable. Science and technology such as gene editing technology may raise related ethical issues. There have also been speculations that cognitive enhancement technologies (CETs) may increase population-level cognitive diversity, e.g. as different people will choose to enhance different aspects of their
cognition Cognition refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, though ...
. Moral enhancement is also a topic in neuroethics.


Stem cell therapy

Most of the issues concerning the uses of
stem cell In multicellular organisms, stem cells are undifferentiated or partially differentiated cells that can differentiate into various types of cells and proliferate indefinitely to produce more of the same stem cell. They are the earliest type of ...
s in the brain are the same as any of the bioethical or purely ethical questions you will find regarding the use and research of stem cells. The field of stem cell research is a very new field that poses many ethical questions concerning the allocation of stem cells as well as their possible uses. Since most stem cell research is still in its preliminary phase most of the neuroethical issues surrounding stem cells are the same as stem cell ethics in general. More specifically the way that stem cell research has been involved in neuroscience is through the treatment of neurodegenerative diseases and brain tumors. In these cases scientists are using
neural stem cell Neural stem cells (NSCs) are self-renewing, multipotent cells that firstly generate the radial glial progenitor cells that generate the neurons and glia of the nervous system of all animals during embryonic development. Some neural progenitor ste ...
s to regenerate tissue and to be used as carriers for
gene therapy Gene therapy is a Medicine, medical field which focuses on the genetic modification of cells to produce a therapeutic effect or the treatment of disease by repairing or reconstructing defective genetic material. The first attempt at modifying ...
. In general, neuroethics revolves around a cost benefit approach to find techniques and technologies that are most beneficial to patients. There has been progress in certain fields that have been shown to be beneficial when using stem cells to treat certain neurodegenerative diseases such as
Parkinson's disease Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms beco ...
. A study done in 2011 showed that
induced pluripotent stem cell Induced pluripotent stem cells (also known as iPS cells or iPSCs) are a type of pluripotent stem cell that can be generated directly from a somatic cell. The iPSC technology was pioneered by Shinya Yamanaka's lab in Kyoto, Japan, who showed in ...
s (iPSCs) can be used to aid in Parkinson's research and treatment. The cells can be used to study the progression of Parkinson's as well as used in regenerative treatment. Animal studies have shown that the use of iPSCs can improve motor skills and dopamine release of test subjects with Parkinson's. This study shows a positive outcome in the use of stem cells for neurological purposes. In another study done in 2011 used stem cells to treat
cerebral palsy Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sens ...
. This study, however, was not as successful as the Parkinson's treatment. In this case stem cells were used to treat animal models who had been injured in a way that mimicked CP. This brings up a neuroethical issue of animal models used in science. Since most of their "diseases" are inflicted and do not occur naturally, they can not always be reliable examples of how a person with the actual disease would respond to treatment. The stem cells used did survive implantation, but did not show significant nerve regeneration. However, studies are ongoing in this area. As discussed, stem cells are used to treat degenerative diseases. One form of a degenerative disease that can occur in the brain as well as throughout the body is an
autoimmune disease An autoimmune disease is a condition arising from an abnormal immune response to a functioning body part. At least 80 types of autoimmune diseases have been identified, with some evidence suggesting that there may be more than 100 types. Nearly a ...
. Autoimmune diseases cause the body to "attack" its own cells and therefore destroys those cells as well as whatever functional purpose those cells have or contribute to. One form of an autoimmune disease that affects the central nervous system is
multiple sclerosis Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This ...
. In this disease the body attacks the
glial cells Glia, also called glial cells (gliocytes) or neuroglia, are non-neuronal cells in the central nervous system (brain and spinal cord) and the peripheral nervous system that do not produce electrical impulses. They maintain homeostasis, form myel ...
that form myelin coats around the axons on neurons. This causes the nervous system to essentially "short circuit" and pass information very slowly. Stem cells therapy has been used to try to cure some of the damage caused by the body in MS.
Hematopoietic stem cell transplantation Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood in order to replicate inside of a patient and to produce ...
has been used to try and cure MS patients by essentially "reprogramming" their immune system. The main risk encountered with this form of treatment is the possibility of rejection of the stem cells. If the hematopoietic stem cells can be harvested from the individual, risk of rejection is much lower. But, there can be the risk of those cells being programmed to induce MS. However, if the tissue is donated from another individual there is high risk of rejection leading to possibly fatal toxicity in the recipient's body. Considering that there are fairly good treatments for MS, the use of stem cells in this case may have a higher cost than the benefits they produce. However, as research continues perhaps stem cells will truly become a viable treatment for MS as well as other autoimmune diseases. These are just some examples of neurological diseases in which stem cell treatment has been researched. In general, the future looks promising for stem cell application in the field of neurology. However, possible complications lie in the overall ethics of stem cell use, possible recipient rejection, as well as over-proliferation of the cells causing possible brain tumors. Ongoing research will further contribute in the decision of whether stem cells should be used in the brain and whether their benefits truly outweigh their costs. The primary ethical dilemma that is brought up in stem cell research is concerning the source of
embryonic stem cells Embryonic stem cells (ESCs) are pluripotent stem cells derived from the inner cell mass of a blastocyst, an early-stage pre- implantation embryo. Human embryos reach the blastocyst stage 4–5 days post fertilization, at which time they consist ...
(hESCs). As the name states, hESCs come from embryos. To be more specific, they come from the
inner cell mass The inner cell mass (ICM) or embryoblast (known as the pluriblast in marsupials) is a structure in the early development of an embryo. It is the mass of cells inside the blastocyst that will eventually give rise to the definitive structures of th ...
of a blastophere, which is the beginning stage of an embryo. However, that mass of cells could have the potential to give rise to human life, and there in lies the problem. Often, this argument leads back to a similar moral debate held around abortion. The question is: when does a mass of cells gain personhood and autonomy? Some individuals believe that an embryo is in fact a person at the moment of conception and that using an embryo for anything other than creating a baby would essentially be killing a baby. On the other end of the spectrum, people argue that the small ball of cells at that point only has the potential to become a fetus, and that potentiality, even in natural conception, is far from guaranteed. According to a study done by developmental biologists, between 75–80% of embryos created through intercourse are naturally lost before they can become fetuses. This debate is not one that has a right or wrong answer, nor can it be clearly settled. Much of the ethical dilemma surrounding hESCs relies on individual beliefs about life and the potential for scientific advancement versus creating new human life.


Disorders of consciousness

Patients in coma, vegetative, or minimally conscious state pose ethical challenges. The patients are unable to respond, therefore the assessment of their needs can only be approached by adopting a third person perspective. They are unable to communicate their pain levels, quality of life, or end of life preferences. Neuroscience and brain imaging have allowed us to explore the brain activity of these patients more thoroughly. Recent findings from studies using
functional magnetic resonance imaging Functional magnetic resonance imaging or functional MRI (fMRI) measures brain activity by detecting changes associated with blood flow. This technique relies on the fact that cerebral blood flow and neuronal activation are coupled. When an area o ...
have changed the way we view vegetative patients. The images have shown that aspects emotional processing, language comprehension and even conscious awareness might be retained in patients whose behavior suggests a vegetative state. If this is the case, it is unethical to allow a third party to dictate the life and future of the patient. For example, defining death is an issue that comes with patients with severe traumatic brain injuries. The decision to withdraw life-sustaining care from these patients can be based on uncertain assessments about the individual's conscious awareness. Case reports have shown that these patients in a persistent vegetative state can recover unexpectedly. This raises the ethical question about the premature termination of care by physicians. The hope is that one day, neuroimaging technologies can help us to define these different states of consciousness and enable us to communicate with patients in vegetative states in a way that was never before possible. The clinical translation of these advanced technologies is of vital importance for the medical management of these challenging patients. In this situation, neuroscience has both revealed ethical issues and possible solutions.


Pharmacological enhancement

Cosmetic neuro-pharmacology, the use of drugs to improve cognition in normal healthy individuals, is highly controversial. Some case reports with the antidepressant
Prozac Fluoxetine, sold under the brand names Prozac and Sarafem, among others, is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It is used for the treatment of major depressive disorder, obsessive–compulsive disorde ...
indicated that patients seemed "better than well", and authors hypothesized that this effect might be observed in individuals not afflicted with psychiatric disorders. Following these case reports much controversy arose over the veracity and ethics of the cosmetic use of these antidepressants. Opponents of
cosmetic pharmacology Cosmetic psychopharmacology, a term coined in 1990 by the psychiatrist Peter D. Kramer and popularized in his 1993 book ''Listening to Prozac'', refers to the use of drugs to move persons from a normal psychological state to another normal state th ...
believe that such drug usage is unethical and that the concept of cosmetic pharmacology is a manifestation of naive consumerism. Proponents, such as philosopher Arthur Caplan, state that it is an individual's (rather than government's, or physician's) right to determine whether to use a drug for cosmetic purposes. Anjan Chatterjee, a neurologist at the
University of Pennsylvania The University of Pennsylvania (also known as Penn or UPenn) is a Private university, private research university in Philadelphia. It is the fourth-oldest institution of higher education in the United States and is ranked among the highest- ...
, has argued that western medicine stands on the brink of a neuro-enhancement revolution in which people will be able to improve their memory and attention through pharmacological means. Jacob Appel, a Brown University bioethicist, has raised concerns about the possibility of employers mandating such enhancement for their workers. The ethical concerns regarding pharmacological enhancement are not limited to Europe and North America; indeed, there is increasing attention given to cultural and regulatory contexts for this phenomenon, around the globe.


Neuromarketing


Political neuromarketing

The politics of neuromarketing is this idea of using advertisements to convince the mind of a voter to vote for a certain party. This has already been happening within the elections throughout the years. In the 2006 reelection of Governor
Arnold Schwarzenegger Arnold Alois Schwarzenegger (born July 30, 1947) is an Austrian and American actor, film producer, businessman, retired professional bodybuilder and politician who served as the 38th governor of California between 2003 and 2011. ''Time'' ...
, he was double digits off in the voting in comparison to his Democratic opponent. However, Schwarzenegger's theme in this campaign was whether or not the voters would want to continue Schwarzenegger's reforms or go back to the days of the recalled governor,
Gray Davis Joseph Graham "Gray" Davis Jr. (born December 26, 1942) is an American attorney and former politician who served as the 37th governor of California from 1999 to 2003. In 2003, only a few months into his second term, Davis was recalled and remov ...
. In normal marketing, voters would use "detail, numbers, facts and figures to prove we were better off under the new governor". However, with neuromarketing, voters followed powerful advertisement visuals and used these visuals to convince themselves that Schwarzenegger was the better candidate. Now, with political neuromarketing, there exists a lot of controversy. The ethics behind political neuromarketing are debatable. Some argue that political neuromarketing will cause voters to make rash decisions while others argue that these messages are beneficial because they depict what the politicians can do. However, control over political decisions could make voters not see the reality of things. Voters may not look into the details of the reforms, personality, and morality each person brings to their political campaign and may be swayed by how powerful the advertisements seem to be. However, there are also people that may disagree with this idea. Darryl Howard, "a consultant to two Republican winners on November 2, says he crafted neuromarketing-based messages for TV, direct mail and speeches for Senate, Congressional and
Gubernatorial A governor is an administrative leader and head of a polity or political region, ranking under the head of state and in some cases, such as governors-general, as the head of state's official representative. Depending on the type of politica ...
clients in 2010". He says that these advertisements that were presented, show honesty and continues to say how he and other politicians decide which advertisements are the most effective.


Neurological treatments

Neuroscience has led to a deeper understanding of the chemical imbalances present in a disordered brain. In turn, this has resulted in the creation of new treatments and medications to treat these disorders. When these new treatments are first being tested, the experiments prompt ethical questions. First, because the treatment is affecting the brain, the side effects can be unique and sometimes severe. A special kind of side effect that many subjects have claimed to experience in neurological treatment tests is changes in "
personal identity Personal identity is the unique numerical identity of a person over time. Discussions regarding personal identity typically aim to determine the necessary and sufficient conditions under which a person at one time and a person at another time ca ...
". Although this is a difficult ethical dilemma because there are no clear and undisputed definitions of personality, self, and identity, neurological treatments can result in patients losing parts of "themselves" such as memories or moods. Yet another ethical dispute in neurological treatment research is the choice of patients. From a perspective of justice, priority should be given to those who are most seriously impaired and who will benefit most from the intervention. However, in a test group, scientists must select patients to secure a favorable risk-benefit ratio. Setting priority becomes more difficult when a patient's chance to benefit and the seriousness of their impairment do not go together. For example, many times an older patient will be excluded despite the seriousness of their disorder simply because they are not as strong or as likely to benefit from the treatment. The main ethical issue at the heart of neurological treatment research on human subjects is promoting high-quality scientific research in the interest of future patients, while at the same time respecting and guarding the rights and interests of the research subjects. This is particularly difficult in the field of
neurology Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal ...
because damage to the brain is often permanent and will change a patient's way of life forever.


Neuroscience and free will

Neuroethics also encompasses the ethical issues raised by neuroscience as it affects our understanding of the world and of ourselves in the world. For example, if everything we do is physically caused by our brains, which are in turn a product of our genes and our life experiences, how can we be held responsible for our actions? A
crime In ordinary language, a crime is an unlawful act punishable by a state or other authority. The term ''crime'' does not, in modern criminal law, have any simple and universally accepted definition,Farmer, Lindsay: "Crime, definitions of", in C ...
in the United States requires a " guilty act" and a " guilty mind". As
neuropsychiatry Neuropsychiatry or Organic Psychiatry is a branch of medicine that deals with psychiatry as it relates to neurology, in an effort to understand and attribute behavior to the interaction of neurobiology and social psychology factors. Within neurop ...
evaluations have become more commonly used in the criminal justice system and
neuroimaging Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Incr ...
technologies have given us a more direct way of viewing brain injuries, scholars have cautioned that this could lead to the inability to hold anyone criminally responsible for their actions. In this way, neuroimaging evidence could suggest that there is no free will and each action a person makes is simply the product of past actions and biological impulses that are out of our control. The question of whether and how personal
autonomy In developmental psychology and moral, political, and bioethical philosophy, autonomy, from , ''autonomos'', from αὐτο- ''auto-'' "self" and νόμος ''nomos'', "law", hence when combined understood to mean "one who gives oneself one' ...
is compatible with neuroscience ethics and the responsibility of neuroscientists to society and the state is a central one for neuroethics. However, there is some controversy over whether autonomy entails the concept of 'free will' or is a 'moral-political' principle separate from metaphysical quandaries. In late 2013 U.S. President
Barack Obama Barack Hussein Obama II ( ; born August 4, 1961) is an American politician who served as the 44th president of the United States from 2009 to 2017. A member of the Democratic Party (United States), Democratic Party, Obama was the first Af ...
made recommendations to the Presidential Commission for the Study of Bioethical Issues as part of his $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. This Spring discussion resumed in a recent interview and article sponsored by
Agence France-Presse Agence France-Presse (AFP) is a French international news agency headquartered in Paris, France. Founded in 1835 as Havas, it is the world's oldest news agency. AFP has regional headquarters in Nicosia, Montevideo, Hong Kong and Washington, ...
(AFP): "It is absolutely critical... to integrate ethics from the get-go into neuroscience research," and not "for the first time after something has gone wrong", said
Amy Gutmann Amy Gutmann (born November 19, 1949) is an American academic and diplomat who is the United States Ambassador to Germany. She was the eighth president of the University of Pennsylvania. In November 2016, the school announced that her contract ...
, Bioethics Commission Chair." But no consensus has been reached.
Miguel Faria Miguel A. Faria Jr. (born 30 September 1952) is Associate Editor in Chief in neuropsychiatry; history of medicine; and socioeconomics, politics, and world affairs of '' Surgical Neurology International'' (SNI) from 2012–present, before that a m ...
, a Professor of Neurosurgery and an Associate Editor in Chief of Surgical Neurology International, who was not involved in the Commission's work said, "any ethics approach must be based upon respect for the individual, as doctors pledge according to the
Hippocratic Oath The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific e ...
which includes vows to be humble, respect privacy and doing no harm; and pursuing a path based on population-based ethics is just as dangerous as having no medical ethics at all". Why the danger of population-based bioethics? Faria asserts, "it is centered on
utilitarianism In ethical philosophy, utilitarianism is a family of normative ethical theories that prescribe actions that maximize happiness and well-being for all affected individuals. Although different varieties of utilitarianism admit different chara ...
, monetary considerations, and the fiscal and political interests of the state, rather than committed to placing the interest of the individual patient or experimental subject above all other considerations". For her part, Gutmann believes the next step is "to examine more deeply the ethical implications of neuroscience research and its effects on society".


Academic journals

* '' Neuroethics'' Main Editor: Neil Levy, CAPPE, Melbourne; University of Oxford Neuroethics is an international peer-reviewed journal dedicated to academic articles on the ethical, legal, political, social and philosophical issues provoked by research in the contemporary sciences of the mind, especially, but not only, neuroscience, psychiatry and psychology. The journal publishes high-quality reflections on questions raised by the sciences of the mind, and on the ways in which the sciences of the mind illuminate longstanding debates in ethics. *
American Journal of Bioethics–Neuroscience
' Main Editor: Paul Root Wolpe, Emory University AJOB Neuroscience, the official journal of the International Neuroethics Society, is devoted to covering critical topics in the emerging field of neuroethics. The journal is a new avenue in bioethics and strives to present a forum in which to: foster international discourse on topics in neuroethics, provide a platform for debating current issues in neuroethics, and enable the incubation of new emerging priorities in neuroethics. AJOB-Neuroscience launched in 2007 as a section of the ''
American Journal of Bioethics The ''American Journal of Bioethics'' is a monthly peer-reviewed academic journal published by Taylor & Francis, covering all aspects of bioethics. It publishes target articles, open peer commentaries, editorials, book reviews, and case studies an ...
'' and became an independent journal in 2010, publishing four issues a year.


See also

*
Bodily integrity Bodily integrity is the inviolability of the physical body and emphasizes the importance of personal autonomy, self-ownership, and self-determination of human beings over their own bodies. In the field of human rights, violation of the bodily int ...
* Neurolaw * Neurosecurity *
Moral psychology Moral psychology is a field of study in both philosophy and psychology. Historically, the term "moral psychology" was used relatively narrowly to refer to the study of moral development. Moral psychology eventually came to refer more broadly to va ...


Notes


References

* Gazzaniga, M. S. (2005). ''The Ethical Brain''. The Dana Press. * * Rees, D. & Rose, S. (2004). ''New brain sciences: perils and prospects''. Cambridge University Press. * Glannon, W. (2006).''Bioethics and the Brain''. Oxford University Press USA * * * * * * Racine E. (2010). ''Pragmatic Neuroethics''. MIT Press, Cambridge MA. * * * * * * * * * * * * * *Neuroscience, Neuropolitics and Neuroethics: The Complex Case of Crime, Deception and fMRI - Springer, n.d. * * * * * * *


External links


"NeuroPolitics"
an entry on '' NeuroWiki''
Neuroethics
Academic journal, editor: Neil Levy.
Neuroethics.upenn.edu

Public access journal articles on neuroethics from University of Pennsylvania

The Center for Cognitive Neuroscience, University of Pennsylvania

Neuroscience, Identity and Society Seminar Series UK
Further links, research papers and news can be found on the background pages.
Neuroethics & Law Blog

BrainEthics Blog
This blog is not active any more, but offers a good bibliography up to 2008.
Center for Neuroscience & Society, University of Pennsylvania

Capital Consortium for Neuroscience: Ethical, Legal and Social Issues

Neuroscience: Ethical, Legal and Social Issues - Third Annual Conference

Neuroethics Research Unit
website of the Neuroethics Research Unit in Montreal, Canada with further links and relevant publications
National Core for Neuroethics at the University of British Columbia publications page

The American Journal of Bioethics

The American Society for Bioethics and Humanities

Cognitive Neuroscience Society

International Neuroethics Society

Bioethics Resources from the NIH


Theme Issue: Ethical Issues in Neuroscience


The President's Council on Bioethics

Johns Hopkins Neuroethics

The Neuroethics Blog
;Programs
Wellcome Centre for Neuroethics, University of OxfordNeuroethics Imaging Group, Stanford Center for Biomedical EthicsNeuroethics Research UnitNational Core for Neuroethics at the University of British ColumbiaNeuroethics Studies Program at Georgetown University Medical CenterJohns Hopkins PEBS Program
{{emerging technologies, topics=yes Bioethics Ethics of science and technology Neuroscience