The Future of Neuroethics - Term Paper Example

The Future of Neuroethics Running Head: The Future of Neuroethics The Future of Neuroethics of The Future of Neuroethics A B S T R A C T Advancement in the different areas in the field of neuroscience has, as a result, raised the public’s awareness on a number of ethical issues concerning long-held views of the Self, the individual’s relationship to society as well as common understanding and acceptance of the brain and the mind as its relates to an individual’s thought, emotion, behavior and experience. This signaled the birth of neuroethics as a discipline. Judy Illes (2006), director of the program in neuroethics and a senior research scholar at the Stanford Center for Biomedical Ethics defined neuroethics as “the study of the ethical, legal and social questions that arise when scientific findings about the brain are carried into medical practice, legal interpretations, and health and social policy.” 1 Perhaps it is to this effect that Glannon (2006) articulates, “advances in basic and clinical neuroscience during the last 25 years, combined with advances in radiology, have provided new insight into the relation between the human brain and mind (37).” These developments that Glannon identified as neuroimaging, psychosurgery, deep-brain stimulation, and psychopharmacology, though may serve certain medical benefits as in the early detection of psychiatric as well as neurological problems, may likewise pose damage to one’s perception of the Self and the world around him. A case in point is Adina Roskies’ (2003) observations on patients with Ventromedial (VM) frontal brain damage, which showed the correlation between moral belief and motivation.3 All these point to an understanding of neuroethics that encompasses both theory (on the physiological make-up of the brain, psychological as well as socio-cultural implication) and its implications to real life situations. This paper will provide an overview on neuroethicscs, developments on the field, consequent issues raised concerning the discipline and a forecast on its future. The Future of Neuroethics The Future of Neuroethics Neuroethics encompasses the innumerable ways in which developments emerging from different branches of clinical neuroscience (neurology, psychiatry, psychopharmacology) and basic neuroscience (cognitive neuroscience, affective neuroscience)4 or scientific findings about the brain intersect with ethical concerns relevant to theoretical, empirical, practical and policy issues at the intersection of neuroscience and bioethics. To some extent, neuroethics endeavors to provide enlightenment on moral behavior and sets parameters on ideologies pertaining to moral obligations. It asserts that morality is multifaceted hence particulars of our moral calculations are not solely subject to the particulars of our biology but as well as on the intervention of other contrasting views pertinent to psychological, philosophical, social, environmental and political assumptions on the world. Ethical issues became a major concern for scholars from various fields as a new field of interest became more prominent—neurotheology. This discipline acknowledges the complexity and diversity of human beliefs by providing a broad conceptual framework to encompass beliefs whether mystical or religious, economic or environmental, political or social or otherwise. Neurotheology, in a nutshell, looks into the study of the brain as it affects these assumed interconnected disciplines by: 1) determining how the discipline identifies, defines, interprets, and shapes its view of things as well as the tools and approaches it uses to understand a given situation; 2) relating to the ways each discipline structures its relationships within the field; 3) engaging in various activities, practices, processes, and procedures to sustain presence and support its growth; and 4) proposing different ways to understand and interpret reality whether of the physical, mental or spiritual kind, or of the personal, social, internal, or external types The Future of Neuroethics Neuroscience, the study of the nervous system, advances the understanding of human thought, emotion, and behavior. Neuroscientists use tools ranging from computers to special dyes to examine molecules, nerve cells, networks, brain systems, and behavior. From these studies, they learn how the nervous system develops and functions normally and what goes wrong in neurological disorders. What is the mind? Why do people feel certain emotions? What are the underlying causes of neurological and psychiatric disorders? These are among the many mysteries that neuroscientists try to solve. Neuroethics is multidisciplinary. It unifies law, philosophy, insights from the humanities and medicine to bear on the the complex interaction of human life, science, and technology. Although its questions are as old as humankind, its origins as a field are more recent and difficult to capture in a single view. Though the interest of the public in the workings of the body and the human mind is an antiquated phenomenon, yet neuroethics is a rather young discipline. According to Zimmer (2004), it is only in the past few centuries that scientists have sought to understand the intricacies of the structure and function of the nervous system and, more recently, the nature of mind and brain (1)5. Illes confirms this saying, “Gone are the days when behaviour was reduced directly to the function of a single gene; instead, behaviour is increasingly seen to be an emergent property of a distributed information processing system, synapses and neurotransmission (977).”6 Since neuroscience uncovered compelling links between biology and moral behavior, a number of advancement in technology, specially in the instruments used in understanding the complexities The Future of Neuroethics of the brain as it affects a person’s experience, moods and behavior and personality, resulted in more provocative issues questioning long-held views of the self and the individual’s relationship to society. If one reflects on the ethical values in science, one is tempted to presuppose that these values are perceptible; they are implicit in everything we do. Scientists who are well equipped, trained and serious about their work bring with them ethical values that allow them to think through, on their own, the implications of their work and its consequences for others. This is not how things are all the time. Even scientists who consider themselves to be well intentioned, and may at times even seem to be so to others, may start out on a course of action that inconspicuously – to them – becomes completely unethical Thus, practical, philosophical, clinical and legal conditions calling for moral actions confront us all the time and the question on whether actions considered morally right based on universally accepted notions on what should be considered acceptable, in a number of situations were considered inappropriate. Likewise, decisions or actions that should have been discarded taking into account the greater damage it will later create are, at times, regarded as morally acceptable. To such instances, Tancredi (2005) suggests, “that although the brain may direct the mind, and genetics creates the foundation for the wiring, environment and experience drive the fine tuning (589).7” Illes and Racine explicitly explain the interdependence of three different but related fields (neuroscience, philosophy and ethics) and the development of neuroethics, as an independent subject saying: The Future of Neuroethics In the 1980s, following a long history of relative mutual ignorance and even hostility (Churchland 1986; Damasio 2000, 7)8, neuroscience and philosophy of mind finally merged in an interdisciplinary academic field: neurophilosophy (Churchland 1986, 2002)9. The aim of this new discipline was to understand the mind and the brain conceptually…using the methods of analytic philosophy, as well as empirically, using neuroscientific methods, in the aim of developing a unified theory of mind/brain. Neuroethics is an area of neurophilosophy and needs to make use of this framework. The neurophilosophical level of interpretation cannot be described as an aspect of the scientific level of interpretation. Scientists, as a rule, are not equipped by their education to perform these conceptual analyses any more than philosophers are taught to perform fMRIs, and neurophilosophy is a subject in its own right. A clear and explicit emphasis on a philosophical level of interpretation can help avoid some serious mistakes, such as introducing terminology with misleading connotations. For example, the authors use the expression “brain maps” as an equivalent to the expression “thought-maps,” which are described as “quantitative profiles of brain function” (Illes and Racine 2005, 2)10. In “Neuroethics: A Modern Context for Ethics In Neuroscience,” Judy Illes and Stephanie Bird (2006)11 outlined the development in neuroscience and the concurrent initiatives that established neuroethics as a discipline (2). First is the is when the prefrontal lobotomies (psychosurgical procedure in which the connections the prefrontal cortex and underlying structures are severed, or the frontal cortical tissue is destroyed, the theory being that this leads to the uncoupling of the brains emotional centres and the seat of intellect)12 were introduced for treatment of mentally ill patients in the late 19th and early 20th centuries. During the 1930s and the 1940s, human experimentation led to the Nuremberg trials [trial of military and political leaders of Nazi Germany before the International Military Tribunal (IMT) and to the twelve trials of other accused war criminals before the United States Nuremberg Military Tribunals (NMT)]13. Then in the 1960’s two major professional neuroscience organizations were established, while in the 1970s and 1980s committees and roundtables devoted to social issues were created within these organizations. Also in the 1970s revelations of the Tuskegee studies and other human subject violations in research led to the publication of the Belmont Report. 399 African- The Future of Neuroethics American men with latent syphilis and 201 men without disease were enrolled in the study based on the results of a 1930 venereal diseases control projects survey. This survey had identified Macon County to have the highest prevalance [sic] of syphilis of the six southern States examined. The rural setting of Tuskegee - a deprived socioeconomic status, high rates of illiteracy  [and] [sic] especially a paucity of medical care - were exploited by the investigators of the syphilis study who led the poor sharecroppers to believe they were being treated for "bad blood," a euphemism for syphilis. The study, which lasted for 40 years included only sporadic clinical reexaminations when a Public Health physician came to Tuskegee and denied the individuals any form of anti-syphilitic therapy.14. In 1984, the Office of Technology Assessment surveyed the potential impact of neuroscience. In 1983, UNESCO founded the International Bioethics Committee (IBC). However, it was only in 1996 that the IBC developed an independent report on the ethical implications of developments in neuroscience. In 2002, the Dana Foundation hosted a meeting called ‘Neuroethics: Mapping the Field’ in San Francisco (CA, USA). In 1983, the Society for Neuroscience extended its commitment to discussions about social issues in neuroscience. In 2003, Annual lectures on Neuroethics formally begun. Finally, in 2005, a ‘Dialogues between Neuroscience and Society’ series was instigated (Bird, 2).15 Consequent fora and public discussions all the more raised the public’s awareness and concern on the ethical implications of the advances in technology on the human brain. These further served as an eye-opener to medical and legal practitioners to consider the ethical implications of their work as well as to private individuals who, in the future, reflecting on having a brain-lift to think on the possible effect on him of the pharmacologic and non-pharmacologic brain enhancements that he might want to apply. The Future of Neuroethics Many ethically significant issues related to human health and research are common topics of debates. Assisted reproduction using advanced technologies, clinical trials on animals as well as on humans whose mental conditions have been considered irremediable, cloning, use of fetal tissues on research are just some of the circumstances that have resulted to an outcry NO from antagonists. Ethical issues have likewise invaded the courtroom. Bayne and Levy (2004) in “Doing without deliberation: automatism, automaticity and moral accountability (209),” 16 report one intriguing courtroom trial where the convicted was acquitted on the grounds that he had committed a murder while in a state of somnambulism (sleep-walking). The article describes how Ken Park in the early morning of May 24, 1987 drove 23 kms. from his home in Pickering, Ontario to his in-law’s house. Upon entering the house with the key he had brought with him, Ken strangulated his father-in-law unconscious, and fatally stabbed his mother-in-law. Afterwards Parks then ‘came to’ and drove to a nearby police station where he reported his actions to the police, saying that he ‘thought he might have killed some people’ (Broughton et al., 1994). Parks was charged with the murder of his mother-in-law, but acquitted on the grounds that he had committed his horrific actions while in a state of somnambulism (sleep-walking), and thus qualified for the defense of automatism (209).17 Bane and Levy assert: Automatism reflects on the common sense judgment that individuals who might have committed heinous crimes on such state are considered not fully accountable of the actions committed hence, should be considered not guilty. The legal defence of automatism is well established (Fenwick, 1990; McSherry, 1998; Ridgway, 1996; Schopp, 1991). Bayne and Levy sum up how individual’s actions are made and may be any of the following: deliberatively, consciously, automatically or automatistically (209).18 Illes and Racine (2005) describe the implications posed by scientific discoveries as three-fold: 1) Scientific interpretation of theories and data; 2) Philosophical interpretation of central The Future of Neuroethics concepts; and 3) Ethical interpretation of problems arising in connection with applications and use (31).19 To better understand neuroethics, we may refer to a simpler categorization put up by neuroethics.upenn.edu, where these ethical concerns are grouped as follows: 1) the “what we can do,” and 2) the “what we know” problems. The first category concerns the potential for misuse or abusive use, of neuroscience findings and methods in functional neuroimaging, brain implants, brain-machine interfaces and psychopharmacology to address social problems that have complex causes. “What we know” problems, on the other hand, re the ethical problems raised by our growing understanding of the neural bases of behavior, personality, consciousness, and states of spiritual transcendence.20 Perhaps it is in this line of reasoning that Hasse, Karlsson (2004) in his article titled, “Psychiatry, neuroscience and free will,” stressed: “Our brains, our behaviors and our selves are intimately connected. This new era also opens important questions concerning diagnosis and pharmacological manipulation of behavior and psychological capacities (eg. aggression, impulsivity, shyness, memory, concentration). All of this has led to the emergence of a new discipline called neuroethics.(as a matter of fact also concepts such as neuroeconomics and neurotheology have emerged). The best scenario of this is that it leads to a better understanding and a reduced stigma of many behavioral or experiental phenomena included in the psychiatric nomenclature (such as social phobia, depression, antisocial personality disorder, borderline personality disorder, obsessive-compulsive disorder.”21 Innovations in the methodologies in treating patients, specifically diseases or problems relating to the brain and brain functioning are proven to have served tremendous functions. Modern technologies afford advanced capabilities for understanding and monitoring human thought and behavior enabled by modern neurotechnologies, “we observe that quantitative profiles of brain function—“thought maps”—once restricted to the domain of medical research The Future of Neuroethics and clinical neuropsychiatry, may now have a natural relevance in our approach to daily life” (Illes and Racine, 2005, 6)22. However, introduction of such methodologies have, to some extent, affect the public’s acceptance of previous notions on self-concept and personhood, to which the following concerns have been raised: 1) invasion of “human thought” privacy, 2) genetic versus neuro determinism. 3) identifying functional patterns relative to sensitive predictors of “neurogentic” disease, and 4) confidentiality and responsibility (Ibid, 12)23. An article titled, “Neuroethics Needed,” sites an interesting comment on the implication of one of the recent technologies in neuroscience, the No Lie MRI and Cephos, which are about to offer functional magnetic resonance imaging (fMRI) brain scans to detect lies. Ethicists are concerned with the result of this technology if one day the scanning technique could be used to accurately discern people’s inner secrets. At the outset, society may, for the first time, hold in its hands a reliable tool with which to finger deceit. Nonetheless, this could have a profound impact on individual privacy and human rights (9)24. Consider the role of physical and psychological factors associated with socioeconomic status in brain development and its functions. If ever brain imaging technologies are used to determine unethical actions, will it prove right in certain situations: people with iron deficiency anemia resulting from poor nutrition, for example, exacerbates the neurotoxic effects of lead often found in the peeling paint of old and poorly maintained shelter. According to Bird (2005), “neurotoxins affect a persons overall neurobiological functioning, and studies have shown that even low levels of lead in the bloodstream are associated with impaired intellectual ability. The degree to which an impaired intellect limits a persons capacity to fully comprehend a situation or The Future of Neuroethics the likely outcome of his actions is still an open question (66).”25 Hence, one may not succinctly assert that a particular action is morally right just by merely looking at the results of whatever technology used to supposedly “unmask” hidden intentions. Furthermore, evidence of brain tumors and other mental states, like the earlier cited example on somnambulism, reasons of insanity, diminished capacity, and impaired consent may sway jurors deciding on the fate of the defendant to accept the latter’s not guilty plea. Ackerman sums up the view of Stanford University law professor Hank Greely: "Even if a neuroscientist could prove ... there was no such thing as free will, we would ignore him in the criminal setting. We would continue to treat people as if they are responsible, whether we actually believe they are or not." In assessing culpability, we are willing to allow that brain function may play a role in behavior, yet at the same rime, we maintain that people ought to answer for behavior," he writes, "but ultimately we must realize that even if the cause of an act (criminal or otherwise) is explainable in terms of brain function, this does not mean that the person who carries out the act is exculpable (66).”26 The second concern confronts reasoning either on the basis of the genetic make-up of the individual or to an individual’s deterministic mind-set. How will we ever determine a felon’s real intent? Should one judge him on merit of his genetic make-up? Or should he be convicted on the notion that a person has a free will and determines the course of his actions bearing in mind the consequence of such action? Other methodologies27 and tools used in neuroscience that becomes the bases for ethical concerns include: psychopharmacology, brain implants and brain-machine interfaces. Psychopharmacology is the primary biotechnological approach to the improvement of cognitive, motor, and emotional functioning. Taking drugs used for brain enahacement like botanical The Future of Neuroethics dietary supplements, amphetamines, modafinil, atomoxetine, Cholinesterase inhibitors, commonly prescribed for the treatment of degenerative dementias, memory enhancers, et cetera. Non-pharmacologic enhancements, on the other hand, include neuroimaging, computerized cognitive exercise, and neuro surgery. Both these methodologies may have both positive and negative effects, hence ethical issues on its continued use are very common (125). Farah (2002)28 categorized objections to enhancements into two broad categories: problems for the individual user and problems for society if use becomes widespread, including raising society’s criteria for normalcy and concerning distribution (1124) (not all may have the capital to obtain such enhancements). The current question for clinical neuropsychology is not whether we should support or engage in neurocognitive enhancement—it is a reality— but what part we want to have in its development and application. The potential to enhance neurocognitive functioning in healthy individuals brings exciting promises and frightening possibilities. As individuals and as a profession, we should consider the role(s) we want to play in the ethics of neurocognitive enhancement and take action before technology and market forces eliminate our options. Neuroscience creates new challenges to a number of distinct disciplines. Understanding the neural correlates of complex behavior, such as moral judgments or rational decision making, is of great interest to natural and social sciences, philosophy of mind, and ethics. To attain such understanding, and be able to use it properly, knowledge from many academic domains is required that meet in the interdisciplinary field of neuroethics.. Finally, as the neuroscience of intentional behavior develops, it will inevitably challenge our ways of thinking about responsibility and blame. As Martha Farah puts it, The Future of Neuroethics “The relationship of self to brain is, if anything, more direct than that of self to genome, and neural interventions are more easily accomplished than genetic interventions. Yet compared to molecular geneticists, who instigated public discussion in the early days of recombinant DNA research, neuroscientists have paid relatively little attention to the social implications of their field. The time is now ripe for examination of these implications, among scientists themselves and in dialog with policy makers and the public (1128)29.” It is high time that responsible individuals must put up continuous campaigns not just to alert the already awakened public but crusades that will identify measures that will ensure that the use of whatever development in neuroscience will not go beyond what should be considered legally and morally correct. The Future of Neuroethics References: 1. Illes, Judy (Ed) (2006). Neuroethics: defining the issues in theory, practice and policy. British Journal Of Neurosurgery. Taylor & Francis Ltd. Oxford: Oxford University Press, 2006. Reviwed by Sahakian, Barbara Jacquelyn. 2. Glannon, Walter (2006). Background Briefing: Neuroethics. Bioethics 20 [1] (online) pp 37-52. 3. Roskies, Adina (2003). . Are ethical judgments intrinsically motivational? Lessons from “acquired sociopathy” [1]. Philosophical psychology. 16 [1] 4. What is neuroethics? Neuroethics.upenn.edu. Accessed on 27 April 2008 from 5. Zimmer, C. (2004) Soul made flesh: the discovery of the brain – and how it changed the world. Free Press in Illes, Judy and Bird, Stephanie (2006). Neuroethics: A Modern Context for Ethics in Neuroscience. Trends In Neuroscience. 30 (10). Accessed on 27 April 2008 from , 1-7. 6. Illes, Judy, et al (2005). International perspectives on engaging the public n neuroethics. Perspectives. Nature Reviews Neuroscience. [6] December 2005. [Online] , p. 977. 7. Tancredi, Laurence (2005). Morality and the brain: hardwire yet flexible. Book Review. 9 [5] © 2006 Nature Publishing Group in Hardwired Behavior: What Neuroscience Reveals about Morality Cambridge University Press, 2005 as reviewed by Illes, Judy. P589. 8. Evers, Kathinka (2005). Neuroethics: a philosophical challenge. American Journal of Bioethcs. March/April 2005, 5 [2]. Taylor & Francis Lmtd. 31-33. 9. Ibid. 10. Ibid. 11. . Illes Judy and Bird, Stephanie (2006). Neuroethics: A Modern Context for Ethics in Neuroscience.Trends in Neuroscience 30 (10). Accessed on 27 April 2008 from , 1-7. 12. Mo (2007). The rise and fall of prefrontal lobotomy. Neurophilosophy. Scienceblogs.com. Accessed on 28 April 2008 from http://scienceblogs.com/neurophilosophy/2007/07/inventing_the_lobotomy.php The Future of Neuroethics 13. Nuremberg trials project: A digital document collection. Harvard Law School Library [Online]. Accessed on 28 April 2008 from 14. Tuskegee syphillys studies. Accessed on 28 April 2008 from 15. Illes Judy and Bird, Stephanie (2006). Neuroethics: A modern context for ethics in neuroscience. Ibid. 16. Tim Bayne , and Levy, Neil. Doing without deliberation: Automatism, automaticity, and moral accountability. International Review of Psychiatry (August 2004), 16(3). {c) Brunner Routledge., 209-215. 17. Ibid. 18. Ibid. 19. Illes, Judy, and Eric Racine (2005). Imaging or imagining? A neuroethics challenge informed by genetics in Evers, Kathinka (2005). Neuroethics: A philosophical challenge. The American Journal of Bioethics. March/April 2005, 5(2): 5–18, © 2005. Taylor & Francis Lmtd.. 20. What is neuroethics? Neuroethics.upenn.edu. Ibid. 21. Hasse Karlsson (Ed) Editorial. Psychiatry, neuroscience and free will. Nordic Journal of Psychiatry. Taylor and Francis Ltd. (Reference: Kennedy D. Neuroscience and Neuroethics. Science 2004; pp 306-373. 22. Illes and Racine (2005). Ibid, p6. 23. Ibid, p12. 24. Neuroethics Needed. 441 [7096] 22 June 2006, © 2002 by the Nature Publishing Group, p 907. 25. Bird, Stephanie (2005). Ethics on the brain. entitled. Neuroethics: Defining the issues in theory, practice, and policy Judy Illes, editor Oxford University Press. www.Science- spirit.org science. (c}Heldref Publications, 66-67. 26. Ibid. 27. Shane, Bush (2006). Neurocognitive enhancement: ethical considerations or an emerging subspecialty. Applied Neuropsychology. 13 [2], pp.125-136. © 2006. Lawrence Erlbaum Associates, Inc. The Future of Neuroethics 28. Farah, Martha J. (2002). Emerging ethical issues in neuroscience. Nature Neuroscience 5 [11], pp. 1124-1129.. © November 2002.EBSCO Publishing. 29. Ibid. Read More