Understanding the Brain

Neuroethics

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Neuroethics is the ethics of neuroscience, and the neuroscience of ethics.[1]

The ethics of neuroscience deals with matters as a subclass of bioethics. Examples include the issue treatment for via the administration of psychopharmaceuticals substances, or mind altering drugs to an autistic person to make them more "normal",[2] or the ethics of brain surgery such as performing an anterior commissurotomy to control epilepsy,[3] a consequentialist moral anthropologist considering the consequences of Mayan brain surgery.

The neuroscience of ethics deals with questions of moral development in the child, as in work of Piaget in the 20th century, or more modern theories of free will that derive from evolutionary theories and molecular biology.[4]

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 that emerged only at the beginning of the 21st century, largely through the oral and written communications of ethicists and philosophers. They state that neuroethics addresses concerns about the effects that neuroscience and neurotechnology will have on other aspects of human life, specifically personal responsibility, law, and justice. Further, they claim that neuroethical problems will become real by the 2020s.

Adina Roskies identified two major divisions in neuroethics: the ethics of neuroscience and the neuroscience of ethics.[5] Research falling under the first area, the ethics of neuroscience, is focused on the ethics of practice of neuroscience and "the implications of our mechanistic understanding of brain function for society... integrating neuroscientific knowledge with ethical and social thought". The neuroscience of ethics borrows from the field of neurophilosophy and examines the neurological foundations of moral cognition.[5]

Definitions

Scope

No specific definition of neuroethics is universally accepted.

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 his paper for Psychological Report, often wrongly mentioned as the first title cointaining the word "neuroethics". Before 1993, the American neurologist Ronald Cranford has used the term (see Cranford 1989).

Illes (2003) records uses, from the scientific literature, from 1989 and 1991.

Current definitions of neuroethics emphasize the ethical, legal and social implications of neuroscience. Writer William Safire defined 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.[6]"

If neuroethics is understood in this way, a typical question investigated by the field might be: What is the difference between treating a human neurological disease and simply enhancing the human brain? Another such question might be: Is it fair for the wealthy to have access to neurotechnology, while the poor do not? Neuroethical problems could complement or compound ethical issues raised by genomics, genetics, and human genetic engineering (see Gattaca argument).

fMRI data

However, Dartmouth College Center for Cognitive Neuroscience Director Michael Gazzaniga argues that definitions such as Safire's are inadequate, since knowledge of brain mechanisms can illuminate a broad range of ethical questions. Gazzaniga states that "neuroethics is more than just bioethics for the brain." In his book The Ethical Brain (see References), he defines the field as: "the examination of how we want to deal with the social issues of disease, normality, mortality, lifestyle, and the philosophy of living informed by our understanding of underlying brain mechanisms" (Gazzaniga's emphasis).

Neuroscientist Michael Gazzaniga puts this view succinctly by stating that "It is—or should be—an effort to come up with a brain-based philosophy of life."

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 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, psychopharmacology, 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.

Important activity in 2002 to 2009: The History of Neuroethics

There is no doubt that people were thinking and writing about the ethical implications of neuroscience 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 upsurge in interest in the ethics of neuroscience, 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 with the journal Neuron, University of Pennsylvania Center for Bioethics with the Center for Cognitive Neuroscience, the Royal Society of London, and Stanford University 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 “---“ and articles on neuroethics began to appear in neuroscience journals, specifically in Nature Neuroscience, Neuron and a special issue of Brain and Cognition.

From 2003-2005 the number of neuroethics meetings, symposia and publications continued to grow. The 38,000 plus members of the Society for Neuroscience 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 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’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 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 Neuroethics Society, an international group of scientists, scholars and students whose mission statement explains that “in classrooms, courtrooms, offices and homes around the world, neuroscience is giving us powerful new tools for achieving our goals and prompting a new understanding of ourselves as social, moral and spiritual beings. The mission of the Neuroethics Society is to promote the development and responsible application of neuroscience through better understanding of its capabilities and consequences.” Steven Hyman agreed to be the first President of the Neuroethics Society.

In 2007 the National Core for Neuroethics was established at the University of British Columbia, in Vancouver, Canada, with mandate to tackle the ethical, legal, policy and social implications of frontier neuroscience through high impact research, education and outreach to ensure the close alignment of innovation and human values.


In January 2009, The University of Oxford established The Wellcome Centre for Neuroethics. The centre aims to address concerns about the effects neuroscience and neurotechnologies will have on various aspects of human life. Its research focuses on five key areas: cognitive enhancement; borderline consciousness and severe neurological impairment; free will, responsibility and addiction; the neuroscience of morality and decision-making; and applied neuroethics.

In the same year, the University of Pennsylvania expanded their neuroethics program with the opening of the cross-school Center for Neuroscience & Society. The stated mission of this Center is to increase understanding of the impact of neuroscience on society through research and teaching, and to encourage the responsible use of neuroscience for the benefit of humanity[1].

Sources of information on neuroethics

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, Biosocities, the Journal of Cognitive Neuroscience, and the forthcoming 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 in neuroethics

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 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 that results from what Peter Kramer called “cosmetic psychopharmacology.”

Nonpharmacologic methods of altering brain function are currently enjoying a period of rapid development, with a resurgence of psychosurgery for the treatment of medication refractory mental illnesses and promising new therapies for neurological and psychiatric illnesses based on deep brain stimulation 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 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 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. A number of different research groups have identified fMRI 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 desire for certain products can purportedly be measured.

Researchers are also finding brain imaging correlates of a myriad of different psychological traits, including personality, intelligence, mental health vulnerabilities, attitudes toward particular ethnic groups, and predilection for violent crime. Unconscious racial attitudes are manifest in brain activation. These capabilities of brain imaging, actual and potential, raise a number of ethical issues. The most obvious concern involves privacy. 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.[7][8]

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 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 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.[9] Anjan chatterjee, a neurologist at the University of Pennsylvania, 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 pharamacological means. Jacob Appel, a Brown University bioethicist, has raised concerns about the possibility of employers mandating such enhancement for their workers.[10][11]

The neuroscience worldview

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? The question of whether and how personal responsibility is compatible with neuroscience is a central one for neuroethics. As neuroscience teaches us more about the way the brain instantiates personality, love and moral values, some in the field have argued that there is less and less reason to hypothesize any immaterial component of a person.

Academic journals

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.

See also

Notes

  1. [Neil Levy, "Neuroethics: Challenges for the 21st Century"]
  2. [Deborah R. Barnbaum, "The Ethics of Autism: Among Them, but Not of Them"]
  3. {see almost any first year psychology text section with split brain patients]
  4. {Jonathan Weiner, "Time, Love, Memory: A Great Biologist and His Quest for the Origins of Behavior"]
  5. 5.0 5.1 Roskies, A. Neuroethics for the New Millenium. Neuron 2002; 35:21-23.
  6. Safire, W. Visions for a New Field of "Neuroethics" Neuroethics Mapping the Field Conference Proceedings. May 13-14, 2002. San Francisco, California
  7. Gordijn Bert; Giordano James J. (2010). Scientific and Philosophical Perspectives in Neuroethics. Cambridge, UK: Cambridge University Press. pp. 256–262. ISBN 0-521-70303-4. 
  8. Goldacre, Ben (30 October 2010). "Lost your libido? Let's try a little neuro-realism, madam: A study of women's libido raises questions about why brain imaging is used to make mental states 'real' for the public". The Guardian. http://www.guardian.co.uk/commentisfree/2010/oct/30/ben-goldacre-bad-science-neuroscience. 
  9. Caplan, Arthur. Is Better Best? A Noted Ethicist Argues in Favor of Brain Enhancement. Scientific American. September, 2003. Pages 04-05
  10. J M Appel When the boss turns pusher: a proposal for employee protections in the age of cosmetic neurology J Med Ethics 2008; 34: 616-618
  11. Jason Kirby. Going to Work on Smart Drugs. Maclean's. October 1, 2008. http://www.macleans.ca/science/health/article.jsp?content=20081001_98115_98115&page=1

References

  • Gazzaniga, M. S. (2005). The Ethical Brain. The Dana Press.
  • Illes, J. (2003, October 24). Neuroethics in a new era of neuroimaging. In American journal of neuroradiology, 24, 1739 – 1741.
  • 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., Bar-Ilan O, Illes J. (2005). fMRI in the public eye. Nature Reviews Neuroscience, 6(2):159-64
  • Farah Martha J. (2002). Emerging ethical issues in neuroscience, Nature Neuroscience, 2002 Vol. 5, No. 11, p. 1123 – 129.
  • Farah Martha J.(2005) Neuroethics: the practical and the philosophical. Trends in Cognitive Sciences January 2005, Vol. 9, No.1, s. 34-40.
  • Illes Judy (2002). Brain and Cognition: Ethical Challenges in Advanced Neuroimaging, Brain and Cognition 2002, 50(3), p. 341-344.
  • Riis P., Neuroethics, European Journal of Neurology 2003, Vol. 10, p. 218-223.
  • The Economist Magazine (2002) Open Your Mind: The Ethics of Brain Science [2]
  • Racine E. (2010). Pragmatic Neuroethics. MIT Press, Cambridge MA.
  • Pontius A. A. (1973). Neuro-ethics of 'walking' in the newborn. Percept Mot Skills 37: 235–245.
  • Pontius A. A. (1993). Neuroethics vs neurophysiologically and neuropsychologically uninformed influences in child-rearing, education, emerging hunter-gatherers, and artificial intelligence models of the brain. Psychol Rep 72: 451–458.
  • Cranford RE (1989). The neurologist as ethics consultant and as a member of the institutional ethics committee. Neurol Clin 7: 697–713.

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