Neuroethics, Misc

It would be unwise to dismiss the possibility of human brain organoids developing sentience. However, scepticism about this idea is appropriate when considering current organoids. It is a point of consensus that a brain-dead human is not sentient, and current organoids lack a functioning brainstem. There are nonetheless troubling early warning signs, suggesting organoid research may create forms of sentience in the near future. To err on the side of caution, researchers with very different views about the neural basis of (...) sentience should unite behind the “brainstem rule”: if a neural organoid develops or innervates a functioning brainstem that regulates arousal and leads to sleep-wake cycles, then it is a sentience candidate. If organoid research leads to the creation of sentience candidates, a moratorium or indefinite ban on the creation of the relevant type of organoid may be appropriate. A different way forward, more consistent with existing approaches to animal research, would be to require ethical review and harm-benefit analysis for all research on sentience candidates. (shrink)

The main message of Neuroethics is that neuroscience forces us to reconceptualize human agency as marvelously diverse and flexible. Free will can arise from unconscious brain processes. Individuals with mental disorders, including addiction and psychopathy, exhibit more agency than is often recognized. Brain interventions should be embraced with cautious optimism. Our moral intuitions, which arise from entangled reason and emotion, can generally be trusted. Nevertheless, we can and should safely enhance our brain chemistry, partly because motivated reasoning crops up in (...) everyday life and in the practice of neuroscience itself. Despite serious limitations, brain science can be useful in the courtroom and marketplace. Recognizing all this nuance leaves little room for anxious alarmism or overhype and urges an emphasis on neurodiversity. The result is a highly opinionated tour of neuroethics as an exciting field full of implications for philosophy, science, medicine, law, and public policy. (shrink)

Kanaan and McGuire elegantly describe three challenges facing the use of fMRI to uncover cognitive mechanisms. They shows how these challenges ramify in the case of identifying the mechanisms responsible for psychiatric disorders. In this commentary, I would like to raise another difficulty for fMRI that also appears to ramify in similar cases. This is that there are good reasons for doubting one of the assumptions on which many fMRI studies are based: that neural mechanisms are always and everywhere sufficient (...) for cognition. I suggest that in the case of the mechanisms underlying psychiatric disorders, this assumption should be doubted. I do not dispute that a malfunctioning neural mechanism is likely to be a necessary component of a psychiatric disorder—as Kanaan and McGuire say, the experimental evidence from cognitive neuropsychiatry gives us excellent reasons to think that this is so. My question is whether a story only in terms of these neural mechanisms is sufficient to explain the mechanism of a psychiatric disorder. Is the reduction, projected by cognitive neuropsychiatry, of psychiatric disorders to disorders in neural functioning even in principle possible? Drawing on recent concerns about the location of mental states, I argue that such a reduction is likely to fail. Even if the considerable problems raised by Kanaan and McGuire for fMRI could be addressed, we have no reason to think that the mechanisms involved in psychiatric disorders are entirely neural, and that fMRI, or even a perfect science-fiction brain-scanner, would be capable of uncovering them. Psychiatric disorders, like numerous other cognitive processes, are liable to cross the brain–world boundary in such a promiscuous way as to be resistant to neural reduction. (shrink)

We are sometimes unsure of the moral status of our relationships with other entities. Recent case studies in this uncertainty include our relationships with artificial agents (robots, assistant AI, etc.), animals, and patients with “locked-in” syndrome. Do these entities have basic moral standing? Could they count as true friends or lovers? What should we do when we do not know the answer to these questions? An influential line of reasoning suggests that, in such cases of moral uncertainty, we need meta-moral (...) decision rules that allow us to either minimize the risks of moral wrongdoing or improve the choice-worthiness of our actions. One particular argument adopted in this literature is the “risk asymmetry argument,” which claims that the risks associated with accepting or rejecting some moral facts may be sufficiently asymmetrical as to warrant favoring a particular practical resolution of this uncertainty. Focusing on the case study of artificial beings, this article argues that this is best understood as an ethical-epistemic challenge. The article argues that taking potential risk asymmetries seriously can help resolve disputes about the status of human–AI relationships, at least in practical terms (philosophical debates will, no doubt, continue); however, the resolution depends on a proper, empirically grounded assessment of the risks involved. Being skeptical about basic moral status, but more open to the possibility of meaningful relationships with such entities, may be the most sensible approach to take. (shrink)

The use of brain technology that contributes to psychological changes has spurred a debate about personal identity. Some argue that neurotechnology does not undermine personal continuity (Levy, 2011) while others argue that it does (Kreitmair, 2019; Schechtman, 2010). To make these assessments, commentators fail to identify psychological changes that cause personal discontinuity. In this paper, I present a view that identifies personal continuity with the maintenance of a self-concept. I argue that a concept of self requires the ability to self-ascribe (...) physical and psychological features and that the diachronic self emerges with self-ascriptions of features that require endurance over time. I maintain that an adequate concept of self does not depend on the maintenance of any particular combination of self-ascriptions and that it can be maintained despite even significant changes in psychological or physical traits. Finally, I apply the self-concept view to identify changes that can result in discontinuity of self. (shrink)

Background: Newer “closed-loop” neurostimulation devices in development could, in theory, induce changes to patients’ personalities and self-perceptions. Empirically, however, only limited data of patient and family experiences exist. Responsive neurostimulation (RNS) as a treatment for refractory epilepsy is the first approved and commercially available closed-loop brain stimulation system in clinical practice, presenting an opportunity to observe how conceptual neuroethical concerns manifest in clinical treatment. Methods: We conducted ethnographic research at a single academic medical center with an active RNS treatment program (...) and collected data via direct observation of clinic visits and in-depth interviews with 12 patients and their caregivers. We used deductive and inductive analyses to identify the relationship between these devices and patient changes in personality and self-perception. Results: Participants generally did not attribute changes in patients’ personalities or self-perception to implantation of or stimulation using RNS. They did report that RNS affected patients’ experiences and conceptions of illness. In particular, the capacity to store and display electrophysiological data produced a common frame of reference and a shared vocabulary among patients and clinicians .Discussion: Empirical experiences of a clinical population being treated with closed-loop neuromodulation do not corroborate theoretical concerns about RNS devices described by neuroethicists and technology developers. However, closed-loop devices demonstrated an ability to change illness experiences. Even without altering identify and self-perception, they provided new cultural tools and metaphors for conceiving of epilepsy as an illness and of the process of diagnosis and treatment. These findings call attention to the need to situate neuroethical concerns in the broader contexts of patients’ illness experiences and social circumstances. (shrink)

The possibility of employing human enhancement interventions to aid in future space missions has been gaining attention lately. These possibilities have included one of the more controversial kinds of enhancements: biomedical moral enhancement. However, the discussion has thus far remained on a rather abstract level. In this paper we further this conversation by looking more closely at what type of interventions with what sort of effects we should expect when we are talking about biomedical moral enhancements. We suggest that a (...) more grounded way to picture moral enhancement, at least in the near term, is to envision a form of cognitive enhancement that also provides some moral benefits by heightening the enhanced person's capability for acting according to their own subjective moral code. While this concept of moral adherence enhancement also has relevance for the moral enhancement discussion more widely, in this paper we apply it specifically in the context of space missions. We argue that there are weighty reasons to consider making biomedical enhancements of the proposed kind a mandatory feature of early-phase long-distance space travel because these missions are high-stakes in nature and take place in an environment where the enhancement could be seen as conferring important advantages while negating many of the traditional arguments weighed against it. (shrink)

Andreas Schmidt and Neil Levy have recently defended nudging against the objection that nudges fail to treat nudgees as rational agents. Schmidt rejects two theses that have been taken to support the objection: that nudges harness irrational processes in the nudgee, and that they subvert the nudgee’s rationality. Levy rejects a third thesis that may support the objection: that nudges fail to give reasons. I argue that these defences can be extrapolated from nudges to some nonconsensual neurointerventions; if Schmidt’s and (...) Levy’s defences succeed, then some nonconsensual neurointerventions neither harness irrationality, nor subvert rationality, nor fail to give reasons. This, I claim, poses a challenge both to opponents of nonconsensual neurointerventions, and to defenders of nudging. (shrink)

Journal of Applied Philosophy, EarlyView.

Animal models have long been used to investigate human mental disorders, including depression, anxiety, and schizophrenia. This practice is usually justified in terms of the benefits (to humans) outweighing the costs (to the animals). I argue on utility maximization grounds that we should phase out animal models in neuropsychiatric research. Our leading theories of how human minds and behavior evolved invoke sociocultural factors whose relation to nonhuman minds, societies, and behavior has not been homologized. Thus it is not at all (...) clear that we are gaining the epistemic or clinical benefits we want from this animal-based research. (shrink)

Recent research in neurochemistry has shown there to be a number of chemical compounds that are implicated in the patterns of lust, attraction, and attachment that undergird romantic love. For example, there is evidence that the phenomenon of attachment is associated with the action of oxytocin and vasopressin. There is therefore some reason to suppose that patterns of lust, attraction, and attachment could be regulated via manipulation of these substances in the brain: in other words, by their use as 'love (...) drugs'. A growing bioethical literature asks searching questions about this prospect, and especially about the use of such drugs to enhance or reignite attachment in flagging relationships. This Element examines some of the central arguments on the topic, and sounds a note of caution. It urges that there are reasons to think the states of attachment produced or facilitated by the use of such drugs would not be desirable. (shrink)

In the debates regarding the ethics of human organoid biobanking, the locus of donor autonomy has been identified in processes of consent. The problem is that, by focusing on consent, biobanking processes preclude adequate engagement with donor autonomy because they are unable to adequately recognise or respond to factors that determine authentic choice. This is particularly problematic in biobanking contexts associated with organoid research or the clinical application of organoids because, given the probability of unforeseen and varying purposes for which (...) a donor’s organoids could be employed and given the different ways in which a donor can relate to her biospecimens, a donor can value her organoids differently in different contexts and her reasons for autonomously permitting use of her cells and tissues in one case may not support an autonomous decision in another. In response, this paper has three aims: firstly, to make the case for why organoid biobanks ought to respect donor autonomy conceived as authentic choice; secondly, to explore the autonomy-respecting limits of established and widely prevalent models of biobank consent; and thirdly, to propose certain conditions that organoid biobanks ought to support or facilitate in order to respect donor autonomy. (shrink)

In this article, we focus on the definition and application of the sliding scale of capacity. We show that the current interpretations of the sliding scale confound distinct features of the medical decision, such as its urgency, its severity, or its complexity, that do not always covary.We propose that the threshold for assessing capacity should be adjusted based solely on the cognitive complexity of the decision at hand. We further suggest that the complexity of a decision should be identified based (...) on a patient’s particular cognitive deficits. We utilize the current research on the types of deficits that characterize amnestic dementias and examine which types of medical decisions might be most complex for patients with that type of dementia. We conclude that applying the sliding scale based on individualized judgments of cognitive complexity will improve accuracy of assessment of capacity and enable capable patients to participate in medical decision making. (shrink)

Alongside the rapid global advances in neuroscientific research, neuroethics has been one of the fastest growing sub-fields within bioethics. With this rapid expansion, bioethicists struggle to kee...

Discussion of the ethics of memory modification technologies has often focused on questions about the limits of their permissibility. In the current paper, I focus primarily on a different issue: when is it rational to prefer MMTs to alternative interventions? My conclusion is that these conditions are rare. The reason stems from considerations of autonomy. When compared with other interventions, MMTs do a particularly poor job at promoting the autonomy of their users. If this conclusion is true, moreover, it provides (...) a fresh perspective on debates about the permissibility of MMTs. On the one hand, for those who would limit the use of MMTs to a narrow range of circumstances, the conclusion that MMTs are rarely preferable gives them further reason to eye MMTs with suspicion. On the other hand, for those who view MMTs as permissible in a wide range of circumstances, the conclusion may deflate their endorsement. (shrink)

This article focuses on justified responses to “immoral” behavior and crimes committed by patients undergoing neuromodulation therapies. Such patients could be held morally responsible in the basic desert sense—the one that serves as a justification of severe practices such as backward‐looking moral outrage, condemnation, and legal punishment—as long as they possess certain compatibilist capabilities that have traditionally served as the quintessence of free will, that is, reasons‐responsiveness; attributability; answerability; the abilities to act in accordance with moral reasons, second‐order volitions, or (...) Deep Self. Recently leading compatibilist neuroethicists added the condition of not feeling alienated from desires motivating a person's action. This article argues against such attempts to determine conditions under which patients undergoing neuromodulation should be subject to negative reactive attitudes and legal punishment. Compatibilism should not be used to justify basic desert moral responsibility and legal punishment. Instead, a new way of thinking about the function of moral responsibility attribution is proposed for patients with neuromodulation. Their compatibilist capabilities should serve as important indicators for determining appropriate, forward‐looking courses of action, such as quarantining and restorative treatment, to ensure the public safety and well‐being of the patients. (shrink)

For nearly two decades, ethicists have expressed concerns that the further development and use of memory modification technologies (MMTs)—techniques allowing to intentionally and selectively alter memories—may threaten the very foundations of who we are, our personal identity, and thus pose a threat to our well-being, or even undermine our “humaneness.” This paper examines the potential ramifications of memory-modifying interventions such as changing the valence of targeted memories and selective deactivation of a particular memory as these interventions appear to be at (...) the same time potentially both most promising clinically as well as menacing to identity. However, unlike previous works discussing the potential consequences of MMTs, this article analyzes them in the context of the narrative relational approach to personal identity and potential issues related to autonomy. I argue that such a perspective brings to light the ethical aspects and moral issues arising from the use of MMTs that have been hidden from previously adopted approaches. In particular, this perspective demonstrates how important the social context in which an individual lives is for the ethical evaluation of a given memory-modifying intervention. I conclude by suggesting that undertaking memory modifications without taking into account the social dimension of a person’s life creates the risk that she will not be able to meet one of the basic human needs—the autonomous construction and maintenance of personal identity. Based on this conclusion, I offer some reflections on the permissibility and advisability of MMTs and what these considerations suggest for the future. (shrink)

The Case of Jim: Jim was arrested arriving at the house of an unattended minor, having brought with him some alcoholic drinks, condoms, and an overnight bag. Records of online conversations Jim was having with the minor give the court strong evidence that the purpose of this meet-up was to engage in sexual relations with the minor. In the course of searching his home computer, investigators also found child pornography. Jim was charged with intent to sexually abuse a child and (...) possession of child pornography. He was given due process, and convicted, by a jury of his peers, on both counts. This is not the first time that Jim has been convicted of a sexual offence. He had been found guilty of possession of child pornography in the past, and served time for it. What should we do with Jim? (shrink)

Dubljević and company’s proposed approach for incorporating a socio-political perspective into neuroethics has clear potential to help mitigate the effects of research ‘hype’ relating to neuroethics. Their approach serves as a social regulation meant to improve the realizability of neuroethics research. Drawing on Dubljević et al. s suggestion, we consider how incorporating a socio-political perspective in other scientific disciplines could help the scientific community as a whole move beyond the infamous ‘reproducibility crisis’ in science. The reproducibility crisis is a concern (...) in science stemming from the revelation that most scientific results are difficult, or impossible, to replicate (Frias-Navarro et al., 2020). By applying the four principles proposed by Dubljević et al., the scientific community can avoid many of the pitfalls that have led to the reproducibility crisis, such as the file drawer effect, a publication bias preventing negative results from being published, or the publish-or-perish culture - the pressure for scientists to publish highly influential papers in high impact journals in order to keep their funding (Rosenthal, 1979; Begley & Ioannidis, 2015). As such, we argue that, in its final form, this socio-political framework begs for true open science, wherein systematically sharing data would enable enlightened policymaking by showing a picture closer to the ground-level realities of scientific research. (shrink)

Many states recognize a legal right to bodily integrity, understood as a right against significant, nonconsensual interference with one’s body. Recently, some have called for the recognition of an analogous legal right to mental integrity: a right against significant, nonconsensual interference with one’s mind. In this chapter, we describe and distinguish three different rationales for recognizing such a right. The first appeals to case-based intuitions to establish a distinctive duty not to interfere with others’ minds; the second holds that, if (...) we accept a legal right to bodily integrity, then we must, on pain of philosophical inconsistency, accept a case for an analogous right over the mind; and the third holds that recent technological developments create a need for a legal right to mental integrity. (shrink)

Open Peer Commentary on P. Zawadzki and A. K. Adamczyk's target article in AJOB Neuroscience on the potential of optogenetics for memory modification. I argue for a radically pluralistic understanding of the notion of authenticity, and highlight the need to further clarify the specific nature of the authors' concern about authenticity, as well as its policy implications.

Loss of personal identity in dementia can raise a number of ethical considerations, including the applicability of advance directives and the validity of patient preferences that seem incongruous with a previous history of values. In this chapter, we first endorse the self-concept view as the most appropriate approach to personal continuity in healthcare. We briefly describe two different types of dementia, Alzheimer’s dementia (AD) and behavioral-variant frontotemporal dementia (bv-FTD). We identify elements considered important for the continuation of a self-concept, including (...) continuation of memories, consistency in personality traits and personal preferences, and continued endorsement of certain moral tenets. We show that, depending on which element is considered most important for personal identity, continuity of a self-concept for individuals with distinct types of dementia will be affected and assessed differently. Utilizing a variety of empirical evidence, we argue that persistence of memory, personality traits, and preferences are not the most important for the maintenance of personal identity. Instead, as studies aimed to capture the folk-psychological view of personal continuity demonstrate, judgements about continuity depend primarily on the persistent commitment to widely shared moral beliefs. Because of that, we argue that individuals with bv-FTD are more likely to lose their sense of self than individuals whose dementia primarily affects memory, such as Alzheimer’s disease. We end the chapter by showing how the importance of moral beliefs for continuity of self can be used to provide guidance to health-care professionals when considering changes in preference by individuals with dementia. (shrink)

With the shortage of physicians and surgeons and increase in demand worldwide due to situations such as the COVID-19 pandemic, there is a growing interest in finding solutions to help address the problem. A solution to this problem would be to use neurotechnology to provide them augmented cognition, senses and action for optimal diagnosis and treatment. Consequently, doing so can negatively impact them and others. We argue that applying neurotechnology for human enhancement in physicians and surgeons can cause injustices, and (...) harm to them and patients. In this paper, we will first describe the augmentations and neurotechnologies that can be used to achieve the relevant augmentations for physicians and surgeons. We will then review selected ethical concerns discussed within literature, discuss the neuroengineering behind using neurotechnology for augmentation purposes, then conclude with an analysis on outcomes and ethical issues of implementing human augmentation via neurotechnology in medical and surgical practice. (shrink)

In the debates regarding the ethics of human enhancement, proponents have found it difficult to refute the concern, voiced by certain bioconservatives, that cognitive enhancement violates the autonomy of the enhanced. However, G. Owen Schaefer, Guy Kahane and Julian Savulescu have attempted not only to avoid autonomy-based bioconservative objections, but to argue that cognition-enhancing biomedical interventions can actually enhance autonomy. In response, this paper has two aims: firstly, to explore the limits of their argument; secondly, and more importantly, to develop (...) a more complete understanding of autonomy and its relation to cognitive enhancement. By drawing a distinction between the capacity for autonomy and the exercise and achievement of autonomy and by exploring the possible effects of cognitive enhancement on both competence and authenticity conditions for autonomy, the paper identifies and explains which dimensions of autonomy can and cannot, in principle, be enhanced via direct cognitive interventions. This allows us to draw conclusions regarding the limits of cognitive enhancement as a means for enhancing autonomy. (shrink)

The current debate on closed-loop brain devices (CBDs) focuses on their use in a medical context; possible criminal justice applications have not received scholarly attention. Unlike in medicine, in criminal justice, CBDs might be offered on behalf of the State and for the purpose of protecting security, rather than realising healthcare aims. It would be possible to deploy CBDs in the rehabilitation of convicted offenders, similarly to the much-debated possibility of employing other brain interventions in this context. Although such use (...) of CBDs could in principle be consensual, there are significant differences between the choice faced by a criminal offender offered a CBD in the context of criminal justice, and that faced by a patient offered a CBD in an ordinary healthcare context. Employment of CBDs in criminal justice thus raises ethical and legal intricacies not raised by healthcare applications. This paper examines some of these issues under three heads: autonomy, human rights, and accountability. (shrink)

There are some distinct methodological challenges, and possible pitfalls, for neuroethics when it evaluates neuroscientific results and links them to issues such as moral or legal responsibility. Some problems emerge in determining the requirements for responsibility. We will show how philosophical proposals in this area need to interact with legal doctrine and practice. Problems can occur when inferring normative implications from neuroscientific results. Other problems arise when it is not recognized that data about brain anatomy or physiology are relevant to (...) the ascription of responsibility only when they are significantly correlated with the psychological capacities contemplated by the legal formulations of responsibility. We will demonstrate this by considering two significant cases concerning psychopathy. Some paradigms that aim at measuring higher-order capacities, such as moral understanding, have limited validity. More robust paradigms for the study of learning in restricted controlled conditions, on the other hand, have limited ecological validity across individuals and context to be of any use for the law. (shrink)

Brain-computer interfaces (BCIs) are devices primarily intended to allow agents to use prosthetic body parts, wheelchairs, and other mechanisms by forming intentions or performing certain mental actions. In this paper I illustrate how the use of BCIs leads to two unique and unrecognized problems of moral luck. In short, it seems that agents who depend upon BCIs for bodily movement or the use of other mechanisms (henceforth “BCI-agents”) may end up deserving of blame and legal punishment more so than standard (...) counterparts simply due to factors beyond their control. My aim is to explore whether we can avoid the implication that BCI-agents are subject to these unique sources of moral luck. In doing so I offer a number of possible solutions and then defend one of these solutions as the best. As it turns out, the solution I defend addresses both problems of moral luck at once and has broader implications for theorizing about moral luck as well as the epistemic condition on moral responsibility. (shrink)

Growing awareness of the ethical implications of neuroscience in the early years of the 21st century led to the emergence of the new academic field of “neuroethics,” which studies the ethical implications of developments in the neurosciences. However, despite the acceleration and evolution of neuroscience research on nonhuman animals, the unique ethical issues connected with neuroscience research involving nonhuman animals remain underdiscussed. This is a significant oversight given the central place of animal models in neuroscience. To respond to these concerns, (...) the Center for Neuroscience and Society and the Center for the Interaction of Animals and Society at the University of Pennsylvania hosted a workshop on the “Neuroethics of Animal Research” in Philadelphia, Pennsylvania. At the workshop, expert speakers and attendees discussed ethical issues arising from neuroscience research involving nonhuman animals, including the use of animal models in the study of pain and psychiatric conditions, animal brain-machine interfaces, animal–animal chimeras, cerebral organoids, and the relevance of neuroscience to debates about personhood. This paper highlights important emerging ethical issues based on the discussions at the workshop. This paper includes recommendations for research in the United States from the authors based on the discussions at the workshop, loosely following the format of the 2 Gray Matters reports on neuroethics published by the Presidential Commission for the Study of Bioethical Issues. (shrink)

The development of novel neurotechnologies, such as brain-computer interface (BCI) and deep-brain stimulation (DBS), are very promising in improving the welfare and life prospects many people. These include life-changing therapies for medical conditions and enhancements of cognitive, emotional, and moral capacities. Yet there are also numerous moral risks and uncertainties involved in developing novel neurotechnologies. For this reason, the progress of novel neurotechnology research requires that diverse publics place trust in researchers to develop neural interfaces in ways that are overall (...) beneficial to society and responsive to ethical values and concerns. In this article, we argue that researchers and research institutions have a moral responsibility to foster and demonstrate trustworthiness with respect to broader publics whose lives will be affected by their research. Using Annette Baier’s conceptual analysis of trust, which takes competence and good will to be its central components, we propose that practices of ethical reflexivity could play a valuable role in fostering the trustworthiness of individual researchers and research institutions through building and exhibiting their moral competence and good will. By ethical reflexivity, we mean the reflective and discursive activity of articulating, analyzing, and assessing the assumptions and values that might be underlying their ethical actions and projects. Here, we share an ethics dialog tool—called the Scientific Perspectives and Ethics Commitments Survey (or SPECS)—developed by the University of Washington’s Center of Neurotechnology (CNT) Neuroethics Thrust. Ultimately, the aim is to show the promise of ethical reflexivity practices, like SPECS, as a method of enhancing trustworthiness in researchers and their institutions that seek to develop novel neurotechnologies for the overall benefit of society. (shrink)

There has been a growing interest in research concerning memory modification technologies (MMTs) in recent years. Neuroscientists and psychologists are beginning to explore the prospect of controllable and intentional modification of human memory. One of the technologies with the greatest potential to this end is optogenetics—an invasive neuromodulation technique involving the use of light to control the activity of individual brain cells. It has recently shown the potential to modify specific long-term memories in animal models in ways not yet possible (...) with other MMTs. As the therapeutic potential of optogenetics has already prompted approval of the first human trials, it is especially important and timely to consider the opportunities and dangers this technology may entail. In this article, we focus on possible consequences of optogenetics as an MMT by analyzing fundamental threats potentially associated with memory modifications: the potential disruption of personality and authenticity. (shrink)

Optogenetics is an invasive neuromodulation technology involving the use of light to control the activity of individual neurons. Even though optogenetics is a relatively new neuromodulation tool whose various implications have not yet been scrutinized, it has already been approved for its first clinical trials in humans. As optogenetics is being intensively investigated in animal models with the aim of developing novel brain stimulation treatments for various neurological and psychiatric disorders, it appears crucial to consider both the opportunities and dangers (...) such therapies may offer. In this review, we focus on the memory-modifying potential of optogenetics, investigating what it is capable of and how it differs from other memory modification technologies. We then outline the safety challenges that need to be addressed before optogenetics can be used in humans. Finally, we re-examine crucial neuroethical concerns expressed in regard to other MMTs in the light of optogenetics and address those that appear to be unique to the memory-modifying potential of optogenetic technology. (shrink)

Innovative practice involves medical interventions that deviate from standard practice in significant ways. For many patients, innovative practice offers the best chance of successful treatment. Because little is known about most innovative treatments, clinicians who engage in innovative practice might consider including extra procedures, such as scans or blood draws, to gather information about the innovation. Such information-gathering interventions can yield valuable information for modifying the innovation to benefit future patients and for designing scientific studies of the innovation. However, existing (...) guidelines do not say when or whether it is appropriate to add potentially risky information-gathering interventions for these purposes. As a result, clinicians may assume that information-gathering interventions are ethically inappropriate and should not be used in innovative practice. This assumption can lead to seriously negative consequences, such as increasing the likelihood that harmful or ineffective innovations will be adopted and creating new barriers to the development of genuinely beneficial treatments. We argue that health care institutions need to promote the responsible use of information-gathering interventions as an adjunct to innovative practice, and that these interventions are not clinical research and should not be subject to research oversight. (shrink)

We have arrived at an inflection point, a moment in history when the sentience, conscious- ness, intelligence, agency, and even the moral agency of many nonhuman animals can no longer be questioned without ignoring centuries of accumulated scientific knowledge. Nowhere is this more true than in our understanding of nonhuman primates (NHPs). A neu- roethics committed to probing the ethical implications of brain research must be able to respond to and anticipate the challenges ahead as brain projects globally prepare to (...) increase the use of NHPs in research. This requires adopting a less anthropocentric focus that includes nonhuman animals within its scope. But the Neuroethics Roadmap represents a missed opportunity to critically examine the future direction of research with NHPs in an ethically-responsive neuroscience. (shrink)

A central question in the current neurolegal and neuroethical literature is how brain-reading technologies could contribute to criminal justice. Some of these technologies have already been deployed within different criminal justice systems in Europe, including Slovenia, Italy, England and Wales, and the Netherlands, typically to determine guilt, legal responsibility, or recidivism risk. In this regard, the question arises whether brain-reading could permissibly be used against the person's will. To provide adequate legal protection from such non-consensual brain-reading in the European legal (...) context, ethicists have called for the recognition of a novel fundamental legal right to mental privacy. In this paper, we explore whether these ethical calls for recognising a novel legal right to mental privacy are necessary in the European context. We argue that a right to mental privacy could be derived from, or at least developed within in the jurisprudence of the European Court of Human Rights, and that introducing an additional fundamental right to protect against brain-reading is not necessary. What is required, however, is a specification of the implications of existing rights for particular neurotechnologies and purposes. (shrink)

Memory technologies are cultural artifacts that scaffold, transform, and are interwoven with human biological memory systems. The goal of this article is to provide a systematic and integrative survey of their philosophical dimensions, including their metaphysical, epistemological and ethical dimensions, drawing together debates across the humanities, cognitive sciences, and social sciences. Metaphysical dimensions of memory technologies include their function, the nature of their informational properties, ways of classifying them, and their ontological status. Epistemological dimensions include the truth-conduciveness of external memory, (...) the conditions under which external memory counts as knowledge, and the metacognitive monitoring of external memory processes. And lastly, ethical and normative dimensions include the desirability of the effects memory technologies have on biological memory, their effects on self and culture, and their moral status. Whilst the focus in the article is largely philosophical and conceptual, empirical issues such as the way we interact with memory technologies in various contexts are also discussed. We thus take a naturalistic approach in which philosophical and empirical concepts and approaches are seen as continuous. (shrink)

The BRAIN 2.0 Neuroethics Report reflects on the ways in which neuroscientific research may inform our understanding of concepts such as consciousness and empathy, and how advances in this understanding might in turn affect practices such as research on non-human animal primates. Generally, the Report calls for “the integration of neuroscience and neuroethics during the remaining years of the BRAIN initiative and beyond” (NIH 2019). In responding to the Report, the articles in this issue grapple with theoretical questions about what (...) the integration of neuroscience and neuroethics might look like, as well as how specific practices might be affected. In this commentary, we don’t grapple with these questions ourselves. Instead, we propose a framework for debates about them. Specifically, we introduce the idea of ‘morally-salient features,’ suggesting that the concept may be helpful in providing a framework for the kinds of questions addressed by the BRAIN 2.0 Neuroethics Report as well as those tackled by the authors of this issue. (shrink)

Rainey et al. (forthcoming) discuss the complications that arise with assigning responsibility for brain computer interface (BCI)-mediated actions. Because BCI-mediated actions can differ from non-BCI-mediated actions in terms of control and foreseeability, the authors suggest that our ethical and legal evaluation of these actions may differ in important ways. While we take no issue with the authors’ discussion or conclusion, we also recognize the difficulty of grappling with the relationship between control, foreseeability, and moral responsibility practices, even without the additional (...) complications introduced by BCI-mediation. In this commentary, we therefore consider BCI-mediated action against the backdrop of a different--perhaps less murky--normative framework: blame. (shrink)

Deep Brain Stimulation (DBS) is an invasive therapeutic method involving the implantation of electrodes and the electrical stimulation of specific areas of the brain to modulate their activity. DBS brings therapeutic benefits, but can also have adverse side effects. Recently, neuroethicists have recognized that DBS poses a threat to the very fabric of human existence, namely, to the selves of patients. This article provides a review of the neuroethical literature examining this issue, and identifies the crucial dimensions related to the (...) self which DBS may endanger—personal identity, authenticity, and autonomy. The most influential theories accounting for these dimensions are analyzed herein, and it is argued that most of these theories require further refinement. This paper also demonstrates the interrelation between personal identity, authenticity, and autonomy, and concludes that one can only fully understand the impact of DBS on the self when all of these factors are taken into account. (shrink)

Would Aquinas hold the view that a patient in a persistent vegetative state (PVS) is something other than a human being? Some recent interpreters have argued for this position. I contend that this reading is grounded in a false symmetry between the three stages of Aquinas’s embryology and the (alleged) three-stage process of death. Instead, I show that there are textual grounds for rejecting the view that the absence of higher brain activity in a patient would lead Aquinas to say (...) that the patient no longer has a rational soul. On my reading of Aquinas, the patient in PVS has a rational soul and is unequivocally a human being. (shrink)

While the presence or absence of consciousness plays the central role in the moral/ethical decisions when dealing with patients with disorders of consciousness (DOC), recently it is criticized as not adequate due to number of reasons, among which are the lack of the uniform definition of consciousness and consequently uncertainty of diagnostic criteria for it, as well as irrelevance of some forms of consciousness for determining a patient’s interests and wishes. In her article, Dr. Specker Sullivan reexamined the meaning of (...) consciousness in the DOC taxonomy and proposed to go away from the routinely used clinical definition of consciousness as “wakeful awareness”, and adopt the meaning that is common in the Eastern tradition which is a form of “pure experience” (Specker Sullivan 2018). She further argued that understanding consciousness as a “pure experience” is ethically relevant for DOC patients. This suggestion is original, novel and important since it preserves the importance of the notion of consciousness for the clinical practice while simultaneously offering an additional ethical tool for the moral decisions in medicine. At the same time, without placing such Eastern notion in the Western tradition it is difficult to see how pure experience could be usefully operationalized to make sense in the clinical practice with DOC patients. It is so because pure experience is a subjective phenomenon which is completely inaccessible in noncommunicative DOC patients and also it does not express behaviorally (Monti et al 2010), therefore some objective-like operationalization is needed. This is why the fusion of Eastern and Western traditions is required to gain the full potential of Dr. Specker Sullivan’s suggestion. We propose that such fusion could be achieved on the basis of the Operational Architectonics (OA) theory of brain-mind functioning (Fingelkurts et al. 2010; 2013a) which suits ideally the purpose due its compatibility with both Western and Eastern traditions of consciousness. (shrink)

It has been argued that a biomarker-informed classification system for antisocial individuals has the potential to overcome many obstacles in current conceptualizations of forensic and psychiatric constructs and promises better targeted treatments. However, some have expressed ethical worries about the social impact of the use of biological information for classification. Many have discussed the ethical and legal issues related to possibilities of using biomarkers for predicting antisocial behaviour. We argue that prediction should not raise the most pressing ethical worries. Instead, (...) issues connected with ‘biologisation’, such as stigmatization and negative effects on self-image, need more consideration. However, we conclude that also in this respect there are no principled ethical objections against the use of biomarkers to guide classification and treatment of adult antisocial individuals. (shrink)

Open Peer Commentary, referring to "Neuroethics at 15: The Current and Future Environment for Neuroethics".

Deep brain stimulation (DBS) is frequently described as a ‘reversible’ medical treatment, and the reversibility of DBS is often cited as an important reason for preferring it to brain lesioning procedures as a last resort treatment modality for patients suffering from treatment-refractory conditions. Despite its widespread acceptance, the claim that DBS is reversible has recently come under attack. Critics have pointed out that data are beginning to suggest that there can be non-stimulation-dependent effects of DBS. Furthermore, we lack long-term data (...) about other potential irreversible effects of neuromodulation. This has considerable normative implications for comparisons of DBS and brain lesioning procedures. Indeed, Devan Stahl and colleagues have recently argued that psychiatric DBS should be subject to the same legal safeguards as other forms of psychosurgery, supporting their position by forcibly criticising the claim that DBS is reversible. In this paper, I respond to these criticisms by first clarifying the descriptive and evaluative elements of the reversibility claim that supporters of DBS might invoke, and the different senses of ‘reversibility’ that we might employ in discussing the effects of medical procedures. I go on to suggest that it is possible to defend a nuanced version of the reversibility claim. To do so, I explain how DBS has some effects that are stimulation dependent in the short term, and argue that these effects can have significant normative implications for patient well-being and autonomy. I conclude that we should not abandon a nuanced version of the reversibility claim in the DBS debate. (shrink)