In the paper “Translational Neuroethics: A Vision for a More Integrated, Inclusive, and Impactful Field,” Wexler and Sullivan provide an insightful analysis of challenges within the field and how t...

Values-Based Medicine (VBM) is the theory and practice of clinical decision-making for situations in which legitimately different values are in play. VBM is thus to values what Evidence-Based Medicine (EBM) is to facts. The theoretical basis of VBM is a branch of analytic philosophy called philosophical value theory. As a set of practical tools, VBM has been developed to meet the challenges of value diversity as they arise particularly in psychiatry. These challenges are illustrated in this paper by a case (...) study of the differential diagnosis between delusion and religious experience. In a traditional model of scientific medicine, such challenges would be expected to become less pressing with advances in medical science. Philosophical value theory suggests, to the contrary, that scientific progress, through opening up an ever-wider range of choices, will increasingly bring the full range and diversity of human values into play not just in psychiatry but in all areas of medicine. The future, then, for medicine, is an integrated model in which VBM and EBM are equal partners in a genuinelyhuman discipline. (shrink)

This study deals specifically with one of the most relevant issues in neuro-ethics, namely the philosophical classification of so-called memory dampening, which refers to the attenuation of traumatic memories with the help of medication. Numerous neuroethical questions emerge from this issue. For example, how is a person’s identity affected by using such drugs? Does one still remain the same person? Would propranolol, for example, as a memory-dampening agent lead to a fundamental change in one’s identity? Are not a (...) person’s negative memories also part of their identity and present personality? These questions are examined from the perspective of the seventeenth-century Islamic philosopher, Mullā Ṣadrā. The goal is to shed light on the neuroethical foundations of memory dampening and personal identity from an Islamic philosophical perspective. (shrink)

This article outlines a few representative areas of research in nano- and neuroscience and then considers the complex continuum of entangled research practices that results. The point of this review is to give a realistic sense of the distributed, opportunistic character of this research, and to show how such emergent practices challenge conventional assumptions about how ethics and science should be advanced. It evaluates the risk profile of research related to that type as if it designated some discrete project. (...) It turns out that summary judgments dismissing any ethical novelty in nanoscience depend on implicit assumptions about the nature of ethical reflection, and these, in turn, depend on assumptions about the nature of pure and applied science. An ethic of nano/neuro convergence needs to explore how these new models might help us more appropriately to manage the complex possibility space associated with emerging research. (shrink)

The increasing use of information and communication technologies (ICT) to help facilitate neuroscience adds a new level of complexity to the question of how ethical issues of such research can be identified and addressed. Current research ethics practice, based on ethics reviews by institutional review boards (IRB) and underpinned by ethical principalism, has been widely criticised and even called ‘imperialist’. In this paper, we develop an alternative way of approaching ethics in neuro-ICT research, based on discourse (...) ethics, which implements responsible research and innovation through dialogues. We draw on our work in Ethics Support, using the Human Brain Project as empirical evidence of the viability of this approach. (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain (...) — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

Motivational enhancement in sport – a form of ‘neuro-doping’ – can help athletes attain greater achievements in sport. A key question is whether or not that athlete deserves that achievement. We distinguish three concepts – praiseworthiness, prizeworthiness, and admiration – which are closely related. However, in sport, they can come apart. The most praiseworthy athlete may not be the most prizeworthy, and so on. Using a model of praiseworthiness as costly commitment to a valuable end, and situating prizeworthiness within (...) the boundaries of the sport, we argue that motivational enhancement in some cases can be compatible with desert. (shrink)

Apart from a short clarification of what neuro-doping is, the aim of this article is twofold. First to give a few reasons in favour of having a special issue on neuro-doping. Second to present an overview of the articles in this issue. One reason for having this special issue, is that it needs to be established whether methods such as transcranial direct-current stimulation should be added to World Anti-Doping Agency’s prohibited list or not, as it is currently under (...) discussion by WADA. Another reason for dealing with the ethics of neuro-doping is that ethical analysis of the use or possible use of neuro-doping in sport is a neglected subject. This issue cover a wide range of ethical analyses of the use of neuro-doping among athletes, chess players, e-gamers and even couch potatoes. For example, whether tDCS ought to be prohibited by WADA and/or the state; or whether its use ought to be promoted by the state; whether the use of neuro-doping is unfair; or whether it should be allowed for businesses to advertise high-sugar, high-caffeine beverages to youngsters. (shrink)

The volume focusses on the ethical dimensions of the technological scaffold embedding human thought and action, which has been brought to attention of the cognitive sciences by situated cognition theories. There is a broad spectrum of technologies co-realising or enabling and enhancing human cognition and action, which vary in the degree of bodily integration, interactivity, adaptation processes, of reliance and indispensability etc. This technological scaffold of human cognition and action evolves rapidly. Some changes are continuous, some are eruptive. Technologies that (...) use machine learning e.g. could represent a qualitative leap in the technological scaffolding of human cognition and actions. The ethical consequences of applying situated cognition theories to practical cases had yet to find adequate attention and are elucidated in this volume. (shrink)

Neuro-technical interfaces are technical devices that bridge the electronic world to neurons with the objective to establish a long term stable contact for bidirectional information exchange. What does that mean in detail and to what kind of machine and for what purpose should the central nervous system, i.e. the brain, be connected? Science fiction literature and movies offer a tremendous variety of usually uncomfortable scenarios including cyborg and robocop super-humans and mass control. Do these implants change the psyche in (...) general and what is feasible in nowadays therapeutic and rehabilitative approaches? In this overview, the author will not answer these questions but tries to deliver an overview of the technological background, the opportunities and the limitations of neuro-technical interfaces to the central nervous system. The fundamental specifications for neuro-technical interfaces will be introduced. Different degrees of implant invasiveness will be discussed and lead to a summary of clinical systems with their application-specific complexity. Actual technological opportunities and limitations will be addressed as well as general physical limitations. Current and future scenarios of neuro-technical interfaces to the central nervous system will be presented from an engineering point of view arising some questions that might be of interest with respect to ethical and societal implications when those interfaces are transferred into clinical practice and public applications. (shrink)

In this article I explain why cognitive science (including some neuroscience) matters for normative ethics. First, I describe the dual-process theory of moral judgment and briefly summarize the evidence supporting it. Next I describe related experimental research examining influences on intuitive moral judgment. I then describe two ways in which research along these lines can have implications for ethics. I argue that a deeper understanding of moral psychology favors certain forms of consequentialism over other classes of normative moral (...) theory. I close with some brief remarks concerning the bright future of ethics as an interdisciplinary enterprise. (shrink)

This month’s issue of _Journal of Medical Ethics_ features a symposium on ‘neuro rights’ and the ‘right to mental integrity’. Medical ethics and the law have long recognised bodily rights—motivating requirements that patients give informed consent before medical interventions are performed on them or before research is conducted on them. Rapid advancements in neuroscience and neurotechnology are raising new questions about the boundaries of bodily rights, whether they extend to the mind or the brain, or whether we need (...) new concepts and rights to apply to the mental sphere. As Farahany 1 writes in her recent (2023) book, ‘The Battle for Your Brain’, the global market for consumer neurotechnology is growing rapidly, expecting to reach US$21 billion by 2026. A growing number of people are using personal neurotechnology that allows them to visualise and track their emotions, levels of alertness and concentration, as well as their actual brain... (shrink)

The field of Neuro-Engineering seems to be on the fast track towards accomplishing its ultimate goal of potentially replacing the nervous system in the face of disease. Meanwhile, the patients and professionals involved are continuously dealing with human bodily experience and especially how neuro-engineering devices could become part of a user’s body schema: the domain of ‘embodied phenomenology’. This focus on embodiment, however, is not sufficiently reflected in the current literature on ethical and philosophical issues in neuro-engineering. (...) In this article we will focus on this lacuna by explaining existing data on neuro-engineering user’s experiences by using phenomenological concepts such as transparency and the concepts that may facilitate this: functionality, sensorimotor feedback and affective tolerance. By introducing and applying these concepts to four real life case examples, we will discuss practical implications and guidelines which can contribute to the actual success of incorporation of the device by the patient. First, we will discuss the importance of a ‘Patient Preference Diagnosis’, which can serve as a way to prepare the patient for the existential reorientation involved in the process. In addition, a Patient Transparency Diagnosis during and after such a process is also relevant when wanting to provide the medical field in general with feedback, and the patient in particular with possibilities to fine-tune the device. From these practical guidelines we will conclude that the phenomenological approach can be very valuable when applied to the field of neuro-engineering. (shrink)

Since the 1990’s, the debate concerning the ethical, legal and societal aspects of ‘neuro-enhancement’ has evolved into a massive discourse, both in the public realm and in the academic arena. This ethical debate, however, tends to repeat the same sets of arguments over and over again. Normative disagreements between transhumanists and bioconservatives on invasive or radical brain stimulators, and uncertainties regarding the use and effectivity of nootropic pharmaceuticals dominate the field. Building on the results of an extensive European project (...) on responsible research and innovation in neuro-enhancement, we observe and encourage that the debate is now entering a new and, as we will argue, more realistic and societally relevant stage. This new stage concerns those technologies that enter the market as ostensibly harmless contrivances that consumers may use for self-care or entertainment. We use the examples and arguments of participants in NERRI debates to describe three case studies of such purportedly innocent ‘toys’. Based upon this empirical material, we argue that these ‘soft’ enhancement gadgets are situated somewhere in the boundary zone between the internal and the external, between the intimate and the intrusive, between the familiar and the unfamiliar, between the friendly and the scary and, in Foucauldian terms, between technologies of the self and technologies of control. Therefore, we describe their physiognomy with the help of a term borrowed from Jacques Lacan, namely as “extimate” technologies. (shrink)

Limitless is a movie (released in 2011) as well as a novel (published in 2001) about a tormented author who (plagued by a writer’s block) becomes an early user of an experimental designer drug. The wonder drug makes him highly productive overnight and even allows him to make a fortune on the stock market. At the height of his career, however, the detrimental side-effects become increasingly noticeable. In this article, Limitless is analysed from two perspectives. First of all, building on (...) the views of the French novelist Emile Zola, the novel is seen as the report of a closely monitored experiment. Subsequently, building on the phenomenology of Ludwig Binswanger, I will show how the cognitive enhancement drug not only boosts the protagonist’s information processing capacities, but also modifies his experience of space and time, his sense of spatiality, his way of being-in-the-world. On the basis of these (complementary) analyses I will indicate how genres of the imagination (such as movies and novels) may play a significant role in assessing the societal implications of emerging technological developments such as neuro-enhancement, especially during the preparatory or anticipatory stage. (shrink)

Joshua Greene argues that cognitive (neuro)science matters for ethics in two ways, the “direct route” and the “indirect route.” Greene illustrates the direct route with a debunking explanation of the inclination to condemn all incest. The indirect route is an updated version of Greene’s argument that dual-process moral psychology gives support for consequentialism over deontology. I consider each of Greene’s arguments, and I argue that neither succeeds. If there is a route from cognitive (neuro)science to ethics, (...) Greene has not found it. (shrink)

One of the new topics that has attracted the attention of researchers in recent years is neuro-marketing. The purpose of the present study is to achieve an insight into the progress of studies on neuro-marketing through review of scientific articles in this field with methodology text-mining. A total of 394 articles were selected between 2005 and 2017 using the search for “neuro-marketing” in valid databases. By reviewing the title, abstract, and keywords at various stages of screening, the (...) researchers selected 311 articles related to the neuro-marketing topic in order to carry out the text mining process. Then, pre-processing of data was performed and using cluster analysis, 6 optimal clusters were obtained according to Davis Bouldin index. Using the multi-attribute decision-making technique, the most important roots were ranked in each cluster. The results showed that interest in research on neuro-marketing has increased in recent years and clusters created around topics such as marketing strategies, advertising and video ads, ethical issues, advertising message components, neuroscience in marketing, economics and consumer behavior, and decision making and brand selection. The study shows that the researchers’ attention is moving from the concepts and principles of the use of neuroscience in marketing, economics and consumer behavior to design and develop marketing strategies using neuroscience. (shrink)

과학 기술은 과도한 발전으로 말미암아 기존에는 우리가 경험하지 못했던 새로운 윤리적 문제들을 출현시키는 원인으로 작용하고 있다. 칼-오토 아펠은 지구적 문제를 해결하기 위한 새로운 윤리로 거시 윤리를 제안하였는데, 그의 주장은 조슈아 그린과 같은 최근의 신경 과학적 관점에서 해석하는 경우에도 유의미한 시사점을 가질 수 있다. 첫째로 문제상황의 진단에 있어서, 아펠이 말하는 ‘전환기적 수준의 위기’는 그린이 제시하는 ‘상식적 도덕의 비극’과 유사하다. 둘째로 문제 해결의 측면에 있어서 아펠이 말하는 ‘거시 윤리’는 그린이 제시하는 ‘수동 모드’와 유사하다. 도덕적 책임 주체의 확대 차원에서 아펠의 주장이 여전히 강점을 (...) 가지므로 현대의 신경 과학도 그를 참고하여 연구를 진행할 필요가 있다. 아펠의 담론 윤리에 근거한 의사소통이 새로운 윤리 문제 해결을 위한 단서가 될 수 있을 것이다. (shrink)

Nanotechnology is an important platform technology which will add new features like improved biocompatibility, smaller size, and more sophisticated electronics to neuro-implants improving their therapeutic potential. Especially in view of possible advantages for patients, research and development of nanotechnologically improved neuro implants is a moral obligation. However, the development of brain implants by itself touches many ethical, social and legal issues, which also apply in a specific way to devices enabled or improved by nanotechnology. For researchers developing nanotechnology (...) such issues are rather distant from their daily work in the lab, but as soon as they use their materials or devices in medical applications such as therapy of brain diseases they have to be aware of and deal with them. This paper is intended to raise sensitivity for the ethical, legal and social aspects (ELSA) involved in applying nanotechnology in brain implants or other devices by highlighting the short term problems of testing and clinical trials within the existing regulatory frameworks (A), the short and medium-term questions of risks in the application of the devices (B) and the long-term perspectives related to problems of enhancement (C). To identify and address such issues properly nanotechnologists should involve ethical, legal and social experts and regulatory bodies in their research as early as possible. This will help to remove pressure from regulatory bodies, to settle public concern and to prevent non-acceptable developments for the benefit of the patients. (shrink)

The debate on “cognitive enhancement” has moved from discussions about enhancement in adults to enhancement in children and adolescents. Similar to positions expressed in the adult context, some have argued that pediatric cognitive enhancement is acceptable and even laudable. However, the implications differ between the adult and the pediatric contexts. For example, in the debate over cognitive enhancement in adults, i.e., those who have legal majority, respect for autonomy demands that personal preferences not be overridden in absence of strong arguments (...) because competent adults are in the best position to recognize and protect their own interests. However, the concepts of best interest and autonomy provide a different picture in the case of pediatric enhancement. In the context of decision-making involving minors, it is assumed that the parents are in the best position to promote and protect the interests of their children and this is chiefly why they are granted the authority to make decisions on their behalf. However, we argue in favor of guarding the physical integrity of children from intrusive medical interventions without medical need and with clear and detrimental effects. We also support leaving open other legitimate life trajectory and career choices, as this is in the best interest of the child, even if they are less in line with the expectations of parents or success in educational settings. In addition, parental decision-making in favor of cognitive enhancement suffers from a lack of information about cognitive enhancers and potential biases. Thus, bearing in mind these issues and the development of volitional capacities of children, we argue that pediatric enhancement is not a morally acceptable practice and “inevitability” can be curbed with clear and fair rules that establish duties of state representatives, physicians, and public institutions. We conclude by canvassing evidence-based policy options that could protect the open future of minors and define the parameters of parental decision-making analogous to the cases of nicotine and alcohol. (shrink)

This article will examine how the notion of emotional authenticity is intertwined with the notions of naturalness and artificiality in the context of the recent debates about ‘neuro-enhancement’ and ‘neuro-psychopharmacology.’ In the philosophy of mind, the concept of authenticity plays a key role in the discussion of the emotions. There is a widely held intuition that an artificial means will always lead to an inauthentic result. This article, however, proposes that artificial substances do not necessarily result in inauthentic (...) emotions. The literature provided by the philosophy of mind on this subject usually resorts to thought experiments. On the other hand, the recent literature in applied ethics on ‘enhancement’ provides good reasons to include real world examples. Such case studies reveal that some psychotropic drugs such as antidepressants actually cause people to undergo experiences of authenticity, making them feel ‘like themselves’ for the first time in their lives. Beginning with these accounts, this article suggests three non-naturalist standards for emotions: the authenticity standard, the rationality standard, and the coherence standard. It argues that the authenticity standard is not always the only valid one, but that the other two ways of assessing emotions are also valid, and that they can even have repercussions on the felt authenticity of emotions. In conclusion, it sketches some of the normative implications if not ethical intricacies that accompany the enhancement of emotions. (shrink)

Within the broad field of human enhancement, pediatric cognitive neuro-enhancement appears to arouse particular interest. The increasing importance of cognitive capacities in our contemporary and cultural context appears to be the main reason for the focus on cognition as the preferred trait of enhancement, while the choice of pharmacological means is based on factors of feasibility, accessibility, and cost. While the ethical issues arising in the adult context have already been extensively covered in the literature, pediatric neuro-enhancement brings (...) with it additional ethical challenges requiring further attention. Although there are numerous important ethical considerations, the focus of this chapter is on the pursuit of normalcy as the goal in pediatric neuro-enhancement. Parental attempts to shape children are not new, and the resources available for them to do so include widespread and mostly uncontroversial tools, such as education. The increasing use of psychotropic drugs, however, reveals the significant impact of the concept of normalcy, which has resulted in a trend to medicalize what used to be considered “normal” behavior. In this context, special challenges are posed by psychiatric disorders, where the familiar treatment-enhancement distinction continues to be relied upon to justify interventions in children. Drawing on the examples of attention deficit/hyperactivity disorder and autism spectrum disorder, it will be argued that children are already being enhanced within psychiatric practice and that this is incompatible with an understanding of disability under a mixed model. (shrink)

Research with human–animal chimera raises a number of ethical concerns, especially when neural stem cells are transplanted into the brains of non-human primates . Besides animal welfare concerns and ethical issues associated with the use of embryonic stem cells, the research is also regarded as controversial from the standpoint of NHPs developing cognitive or behavioural capabilities that are regarded as “unique” to humans. However, scientists are urging to test new therapeutic approaches for neurological diseases in primate models as they better (...) mimic human physiology than all current animal models. As a response, various countries have issued reports on the topic. Our paper summarizes the ethical issues raised by research with human–animal brain chimeras and compares the relevant regulatory instruments and different recommendations issued in national reports from three important European research nations: Germany, Switzerland and the United Kingdom. We assess and discuss the focus and priorities set by the different reports, review various reasons for and perspectives on the importance of the brain in chimera research, and identify critical points in the reports that warrant further specification and debate. (shrink)

For centuries, religion and philosophy have been the primary basis for efforts to guide humans to be more ethical. However, training in ethics and religion and imparting positive values and morality tests such as those emanating from the categorical imperative and the Golden Rule have not been enough to protect humankind from its bad behaviors. To improve ethics education educators must better understand aspects of human nature such as those that lead to “self-deception” and “personal bias.” Through rationalizations, (...) faulty reasoning and hidden bias, individuals trick themselves into believing there is little wrong with their own unethical behavior. The application of science to human nature offers the possibility of improving ethics education through better self-knowledge. The author recommends a new paradigm for ethics education in contemporary modern society. This includes the creation of a new field called “applied evolutionary neuro-ethics” which integrates science and social sciences to improve ethics education. The paradigm can merge traditional thinking about ethics from religious and philosophical perspectives with new ideas from applied evolutionary neuro-ethics. (shrink)

This paper discusses the possible use of functional magnetic-resonance imaging as potentially useful in jury selection. The author suggests that neuro-voir could provide greater impartiality of trials than the standard voir, while also preserving existing privacy protections for jurors. He predicts that ability to image and understand a wide range of brain activities, most notably bias-apprehension and lie detection, will render neuro-voir dire invaluable. However currently, such neuro-solutions remain preliminary.

The article deals with the philosophical problem field of modern neuroethics. The general idea of the state of modern neuroethics is given and it is shown that research in this area encompasses both fundamental problems that classically belonged to the field of philosophy research (for example, such as the problem of psychophysical dualism, the physical bases of consciousness, freedom of will and its interrelation with brain activity) and problems with applied orientation, explicating the ethical-social and legal dimension of innovation development (...) in the field of neuroscience and actualizing the analysis of their social risks. It is shown that the development of neuro-ethics in the modern world became possible thanks to a special way of functioning of modern science, which was called the technology of science and to the development of the phenomenon of technological development ethification, which in practical terms was expressed in the study of the problem of the correspondence of the results of innovative scientific and technical projects to the interests of various social groups, their expectations and values, and also helped to determine the status of new technologies in relation to social reality. The article gives an idea of the existing normative field necessary for the development of neuro-ethics. On the basis of using the resource of discourse analysis of R. Harre, who singled out personal grammar (P-grammar), organism grammar (O-grammars) and molecular grammar (M-grammar), a philosophical analysis of such a problem of modern neuroethics as brain death was carried out. Also was given a structural description of new biotechnogenic identities of human being. The conclusion is drawn that the concept of brain death is an example of the conventional nature of scientific truth, the formation of which is influenced by various socio-cultural and economic factors. In the context of the development of neuroscience and the emergence of new methods of brain regeneration, it can be rethought. (shrink)

We discuss an epileptic incident in an undiagnosed 13-year old girl participating in a clinical study investigating the effects of transcranial direct current stimulation in healthy children and adolescents. This incident poses important research ethics questions with regard to study design, especially pertaining to screening and gaining informed consent. Potential benefits and problems of the incident also need to be considered. The ethical analysis of the case presented in this paper has been informed by an in-depth interview conducted after (...) the incident with the child and the accompanying parent. We discuss the ethical implications of the epileptic incident, the need for improving screening procedures for studies with minors and for providing more effective communication. This case also underscores the problem of undetected teenage epilepsy in neuropsychological clinical studies and the necessity of raising more awareness of this issue. Since research in tDCS is an active and expanding field, we conclude with providing some recommendation that could ensure that future research on tDCS, or other therapies and neuro-interventions where there is a risk of triggering an epileptic seizure, take into account the specifics of teenage epilepsy and the need for more thorough provision of information during the process of gaining informed consent. (shrink)

This paper addresses the question of how incidental findings in clinical research should be managed by researchers, focusing in detail on IFs discovered in neuroimaging research. It begins by engaging the larger research ethics issue of whether researchers have any obligations of clinical care to participants, and assesses the content and merits of one particular framework for answering this question, Richardson and Belsky's ancillary care model. From here the paper develops an organizational structure for integrating the ancillary care model (...) with existing research ethics standards, with the aim of better understanding their respective domains. It makes a distinction between incidental findings that are anticipated by informed consent documents, and those that are unanticipated, arguing that this distinction is critical for evaluating researcher obligations. Finally, it takes on the issue of incidental findings in neuroimaging research, translating the standards discussed into recommendations for both unanticipated and anticipated findings. (shrink)

In caring for pediatric patients, a multifaceted approach in decision-making is utilized. The role of the medical team in complementary and alternative medicine is controversial. In cases of conventional treatment refusal by parents in pursuit of complementary and alternative medicine, there must be balanced decision-making, autonomy, and the best interest of the child. This report highlights two illustrative cases (ages 4, 17 years) of patients with brain tumor, whereby parents refused postoperative conventional therapy involving chemoradiotherapy, in pursuit of complementary and (...) alternative medicine alone. Parental decision-making in complementary and alternative medicine, in lieu of medical recommendations, poses an ethical and legal dilemma that may impede care of the pediatric patient and compromise outcome of oncological care. (shrink)

According to proponents of the extended mind, bio-external resources, such as a notebook or a smartphone, are candidate parts of the cognitive and mental machinery that realises cognitive states and processes. The present chapter discusses three areas of ethical concern associated with the extended mind, namely mental privacy, mental manipulation, and agency. We also examine the ethics of the extended mind from the standpoint of three general normative frameworks, namely, consequentialism, deontology, and virtue ethics.

Catholic theology’s traditional understanding of the spiritual nature of the human person begins with the idea of a rational soul and human mind that is made manifest in free will—the spiritual experience of the act of consciousness and cause of all human arts. The rationale for this religion-based idea of personhood is key to understanding ethical dilemmas posed by modern research that applies a more empirical methodology in its interpretations about the cause of human consciousness. Applications of these beliefs about (...) the body/soul composite to the theory of evolution and to discoveries in neuroscience, paleoanthropology, as well as to recent animal intelligence studies, can be interpreted from this religious and philosophical perspective, which argues for the human soul as the unifying cause of the person’s unique abilities. Free will and consciousness are at the nexus of the mutual influence of body and soul upon one another in the traditional Catholic view, that argues for a spiritual dimension to personality that is on a par with the physical metabolic processes at play. Therapies that affect consciousness are ethically problematic, because of their implications for free will and human dignity. Studies of resilience, as an example, argue for the greater, albeit limited, role of the soul’s conscious choices in healing as opposed to metabolic or physical changes to the brain alone. (shrink)

ABSTRACT:Psychedelics have again become a subject of widespread interest, owing to the reinvigoration of research into their traditional uses, possible medical applications, and social implications. As evidence for psychedelics' clinical potential mounts, the field has increasingly focused on searching for mechanisms to explain the effects of psychedelics and therapeutic efficacy of psychedelic-assisted therapy (PAT). This paper reviews three general frameworks that encompass several prominent models for understanding psychedelics' effects—specifically, neurobiological, psychological, and spiritual frameworks. Following our review, the implications of each (...) framework for ethics and professional competencies in the implementation of psychedelics as medicines are explored. We suggest that interdisciplinary education may be necessary to improve communication between researchers, develop models that effectively incorporate multiple levels of analysis, and facilitate collaboration between professionals with diverse backgrounds in the implementation of psychedelic medicines. We also address pitfalls associated with overemphasis on neuro-mechanisms, risks associated with instigating vulnerable states of consciousness, and hurdles associated with the integration of spiritual frameworks in medicine. Ultimately, as psychedelics push the boundaries of explanatory frameworks focused on one level of analysis, developing new and more useful models to reflect knowledge being produced in this field should be a central aim of psychedelic science going forward. (shrink)

Understanding Eating Disorders is an original contribution to the field of healthcare ethics. It develops a new theory concerning the moral basis of eating disorders, and places such disorders for the first time at the centre of philosophical discourse. The book explores the relationship that people have with food and their own body by looking at genetics and neuro-physiology, sociology and family studies, clinical psychology and psychiatry, and frames abnormal eating at the extreme of a spectrum of normal (...) behaviours, directed by moral values. Giordano argues that abnormal eating is not a psycho-pathological phenomenon, but the coherent implementation of ordinary moral values with a long tradition in Western culture. The book also contains a detailed analysis of UK legislation, accompanied by a timely critique of the law on treatment of mental disorders in general and of eating disorders in particular. (shrink)

Freud's legacy deriving from his work The project for a scientific psychology (1895) could give a new impetus to the dialogue between psychoanalysis and neurosciences. A rapproachment phase is warrented. Based on the work of psychoanalysts who are themselves neuroscientists (such as Mauro Mancia, Martha Koukkou and Harold Shevrin) or have a long term dialogue with neuroscientists (Arnold Modell), three points of epistemological congruence are described: dualism is no longer a satisfactory solutioncautions for the centrality of interpretation (hermeneutics)the self-criticism of (...) neuroscientists. (shrink)

In their article published in Nanoethics, “Ethical, Legal and Social Aspects of Brain-Implants Using Nano-Scale Materials and Techniques”, Berger et al. suggest that there may be a prima facie moral obligation to improve neuro implants with nanotechnology given their possible therapeutic advantages for patients [Nanoethics, 2:241–249]. Although we agree with Berger et al. that developments in nanomedicine hold the potential to render brain implant technologies less invasive and to better target neural stimulation to respond to brain impairments in the (...) near future, we argue against presenting the development of nanobionic clinical devices in terms of a moral obligation to conduct this research. In the first part of the paper, we consider what a duty to pursue new technologies might mean, and in the second we explore some of the negative consequences of defending such development as a moral obligation based on potential benefit. We argue that promoting the advances available to brain implants through developments in nanotechnology and bionics could contribute to medical rhetoric that indirectly increases the risk of exposing patients to harm when participating in clinical trials. We argue that rather than there being a moral obligation to improve nanobionics implants because of their potential benefit, the pursuit of improved neuro implants must be balanced against the prima facie obligations to protect patients against harm and to promote and protect patient autonomy. (shrink)

BackgroundNeuroethics describes several interdisciplinary topics exploring the application and implications of engaging neuroscience in societal contexts. To explore this topic, we present Part 3 of a four-part bibliography of neuroethics’ literature focusing on the “ethics of neuroscience.”MethodsTo complete a systematic survey of the neuroethics literature, 19 databases and 4 individual open-access journals were employed. Searches were conducted using the indexing language of the U.S. National Library of Medicine. A Python code was used to eliminate duplications in the final bibliography.ResultsThis (...) bibliography consists of 1137 papers, 56 books, and 134 book chapters published from 2002 through 2014, covering ethical issues in neuroimaging, neurogenetics, neurobiomarkers, neuro-psychopharmacology, brain stimulation, neural stem cells, neural tissue transplants, pediatric-specific issues, dual-use, and general neuroscience research issues. These works contain explanations of recent research regarding neurotechnology, while exploring ethical issues in future discoveries and use. (shrink)

Metaphysical and epistemological dualism informs much contemporary discussion of the relationships of science and religion, in particular in relation to the neurosciences and the religious understanding of the human person. This dualism is a foundational artifact of modern culture; however, contemporary scientific research and historical theological scholarship encourage a more holistic view wherein human personhood is most fittingly understood as an emergent phenomenon of, but not simply reducible to, evolutionary and developmental neurobiology.

Neuro-ethics is probablу the fastest-growing part of applied ethics. Its main thesis, or hypothesis, is that certain natural processes in brain and nerves produce certain moral, and immoral, behaviors. All these processes can be explained causally, and (if this is so) neuro-ethics might be the most recent extension of neuroscience. There are some metaphysical and ethical pitfalls to be considered, however, like the (incorrect) conflation of causal explanation and rational justification in defining values, and not (...) only for non-moral, but also for specifically moral values. Certainly, the knowledge of how neurological processes function could help enhance the quality of human life, not only in coping with its defects but also in improving the so-called "normal life." This implies that neuroethics is instrumental and, in the end, value-neutral. However, it seems that neuroethics aspires to go further than that: to explain how goals come into existence and what their articulation should look like. All of this should be causally explained, or at least be causally explainable. This produces issues worthy of deeper analysis, including consideration of distinctions between causes and reasons, explanations and justifications, or the one between means and ends. It is also important to consider potential applications of neuroethics, summarizing benefits and risks, and considering how neuroethics may best help in advancing the overall quality of human life, individual and social. (shrink)

Advances in neuroscience are changing how mental health issues such as addiction are understood and addressed as a brain disease. Although a brain disease model legitimizes addiction as a medical condition, it promotes neuro-essentialist thinking and categorical ideas of responsibility and free choice, and undermines the complexity involved in its emergence. We propose a “biopsychosocial systems” model where psychosocial factors complement and interact with neurogenetics. A systems approach addresses the complexity of addiction and approaches free choice and moral responsibility (...) within the biological, lived experience and sociohistorical context of the individual. We examine heroin-assisted treatment as an applied case example within our framework. We conclude with a discussion of the model and its implications for drug policy, research, addiction health care systems and delivery, and treatment of substance use problems. (shrink)

The claim of this paper is to present Spinoza’s view on self-esteem and positive reciprocity, which replaces the human being in a monistic psycho-dynamical affective framework, instead of a dualistic pedestal above nature. Without naturalising the human being in an eliminative materialistic view as many recent neuro-scientific conceptions of the mind do, Spinoza finds an important entry point in a panpsychist and holistic perspective, presenting the complexity of the human being, which is not reducible to the psycho-physiological conditions of (...) life. From a panpsychist point of view, qualities and values emerge from the world, in a situation similar to what could be seen in animism, or early childhood psychology, where the original distance between the mind and the exterior thing is reduced ad minima, and both can even interrelate in a confusing manner. Human reality is nevertheless a social reality, it supposes a basis for shared competencies, that we will present as grounded on the one hand of the sustaining character of the essence of the animal-man as will-to-power. Negatively speaking we all share same asocial tendencies and affects. This aspect is not only negative but it is also a will to develop and master the environment, because values have an onto-metaphysical immanent dimension in nature, not because there is an individual bottom-up will to survive, but rather a will to live in harmony with the surrounding world. On the other hand, we shall see that Spinoza understood and described perfectly the power of the mind over the power of the affects, as a co-constituting dimension, which is alienating natural dependencies, leaving an inner space for the objectification of ethical values, not related to mere compensation mechanisms. (shrink)

In recent years, discussion around memory modification interventions has gained attention. However, discussion around the use of memory interventions in the criminal justice system has been mostly absent. In this paper we start by highlighting the importance memory has for human well-being and personal identity, as well as its role within the criminal forensic setting; in particular, for claiming and accepting legal responsibility, for moral learning, and for retribution. We provide examples of memory interventions that are currently available for medical (...) purposes, but that in the future could be used in the forensic setting to modify criminal offenders’ memories. In this section we contrast the cases of dampening and enhancing memories of criminal offenders. We then present from a pragmatic approach some pressing ethical issues associated with these types of memory interventions. The paper ends up highlighting how these pragmatic considerations can help establish ethically justified criteria regarding the possibility of interventions aimed at modifying criminal offenders’ memories. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Power Do I Have? A Nursing Student’s Concerns Lead to a Passion for EthicsAnonymous OneThe day began like many in our ten–week rotation, around the large table in the brightly lit ICCU nurses’ station. Report, which was given by the night charge nurse, included information on all the patients on the unit. Since I had cared for A. G. the previous day, I was eager to know how (...) she had spent the night. She had a debilitating neuro–muscular disease known as myasthenia gravis. Placed on the ventilator days before, it was reported that she was likely to be dependent on the machine for life. In the late 1970’s there were very few facilities that accepted ventilator dependent patients. She might be with us for a long time.When I entered her room for the first time, I saw a frail older woman with kind eyes and a warm smile. She was breathing with the help of the ventilator through her tracheostomy tube. I learned through her chart that she had no known family. On the day I took care of her, no one came to see her and she had no visitors the previous evening. She lived in a local long–term care facility and was brought to the hospital after she developed respiratory distress. A. G. was unable to move in the bed due to her condition and required frequent suctioning along with turning and repositioning for comfort.Despite her weakness, A. G. was able to communicate silently by mouthing the words for what she wanted and by nodding and shaking her head. I found her to be quite skilled in non–verbal [End Page 93] communication since it took minimal effort to understand what she wanted, but the activity tired her easily. I had just completed A. G.’s morning care when her physician came in to examine her. After completing his assessment, he stopped and leaned in closely to speak with her. He began asking a number of questions about whether she wanted to spend the rest of her life in this way, on a ventilator. She shook her head. Continuing the line of questioning in different ways, she responded to him. I wondered why he was asking these questions. After seeing her response, the physician asked me to get 30 mg of morphine from the narcotics cabinet. Although I didn’t understand the implication of the request, I complied.While I was retrieving the medication from the narcotics cabinet, the charge nurse came to tell me I was being reassigned to a new admission. When I asked why, she told me she couldn’t discuss it, but asked me to please do what she said. I left her standing there, wondering what was going on. After assisting with the new admission, I went back to see A.G.; her door was closed. When I opened the door, the ventilator tubing hung over the side of the machine. Looking down at the bed, I was shocked to find A.G. had been disconnected. She was dead. In a state of disbelief and panic, I sought out the charge nurse to find out what happened. It was clear that I was not to know. I asked her a number of questions but she adeptly changed the subject and redirected me to other activities. By then it was lunchtime and my instructor had left the unit. I asked to be excused and went to seek her out.When I told my instructor what happened, a look of doubt came over her face. “You think Doctor M. killed your patient? That would never happen.” Although I tried to tell her the story, she too, dismissed me, telling me my story didn’t make sense. I was distraught. An overwhelming sense of dread came over me and I began to cry. She encouraged me to go home, which I did.Happily, I had the weekend to recover before returning to clinical. I never found out what happened to A. G. and neither my instructor nor the charge nurse ever spoke to me about my experience. In fact, it seemed no one believed my story... (shrink)

Electroconvulsive therapy (ECT), an efficient psychiatric treatment method, is one of the most controversial and the most stigmatized therapeutic approaches in medicine. ECT uses transcranial electrical impulses to induce artificial epileptiform paroxysm. For the first time it was used in 1938 by Italian neuro-psychiatrists Ugo Cerletti and Lucio Bini in treatment of schizophrenia. Efficacy of the method was proven in clinical practice, clinical studies and meta-analyses. ECT is the most efficient in the treatment of mood disorders and in lesser (...) extent in some other disorders. Important advance in ECT was the introduction of anaesthesia and muscle relaxation. It reduced adverse effect incidence and severity. Currently, ECT is associated mostly with anaesthesia adverse effects. Other adverse reactions include muscle pain, headache, prolonged paroxysm, cardiopulmonary complications. The most discussed and the most disturbing adverse effect is memory impairment which is usually transient. Incidence and severity of adverse effects is comparable to other therapeutic modalities. Examining the available information it appears, that modern practice of ECT in Europe (European Union member states) and USA is, apart from a few exceptions, in accordance with principles of beneficence and to some extent with autonomy and nonmaleficence. In many countries, the principle of justice is not respected – either because of limited availability or restrictive laws. In the Czech Republic the problem is non-existence of codified treatment guidelines and insufficient training of medical specialists. Aside from this, position of ECT in the Czech Republic is similar to that in the rest of Europe and in USA. (shrink)

In this article, I explore select case studies of Parkinson patients treated with deep brain stimulation in light of the notions of alienation and authenticity. While the literature on DBS has so far neglected the issues of authenticity and alienation, I argue that interpreting these cases in terms of these concepts raises new issues for not only the philosophical discussion of neuro-ethics of DBS, but also for the psychological and medical approach to patients under DBS. In particular, I (...) suggest that the experience of alienation and authenticity varies from patient to patient with DBS. For some, alienation can be brought about by neurointerventions because patients no longer feel like themselves. But, on the other hand, it seems alienation can also be cured by DBS as other patients experience their state of mind as authentic under treatment and retrospectively regard their former lives without stimulation as alienated. I argue that we must do further research on the relevance of authenticity and alienation to patients treated with DBS in order to gain a deeper philosophical understanding, and to develop the best evaluative criterion for the behavior of DBS patients. (shrink)

In light of the recent events of terrorism and publicized cases of mass slayings and serial killings, there have been calls from the public and policy-makers alike for neuroscience and neurotechnology (neuroS/T) to be employed to intervene in ways that define and assess, if not prevent, such wanton acts of aggression and violence. Ongoing advancements in assessment neuroS/T have enabled heretofore unparalleled capabilities to evaluate the structure and function of the brain, yet each and all are constrained by certain technical (...) and practical limitations. In this paper, we present an overview of the capabilities and constraints of current assessment neuroS/T, address neuro-ethical and legal issues fostered by the use and potential misuse of these approaches, and discuss how neuroethics may inform science and the law to guide right and sound applications of neuroS/T to “deliver us from evil” while not being led into temptations of ampliative claims and inapt use. (shrink)