Neuroethics

While neurorights are emerging as a potentially novel set of human rights in an age of neurotechnologies, most scholarly and policy debate to date has focused on defining and justifying these norms and their connection to existing rights. This article instead assumes some form of neurorights claims will find recognition in at least some existing or novel law and seeks to anticipate potential legal and regulatory hurdles to the successful implementation of this class of norms. After reviewing the ongoing conversations (...) around neurorights and reflecting on the move towards their legal construction, we draw on insights from fields including international law, political economy, and regulatory theory to identify and consider likely hurdles or coming challenges to implementation, including rights balancing, legal fragmentation, appropriate remedies, and issues around transnational and nonstate action and enforcement. The article then presents a research agenda calling for further analysis of these and other implementation challenges and reflects on how assessing these considerations in advance could inform better policy and advocacy. (shrink)

Should we implement biomedical interventions like psychopharmaceuticals or brain stimulation that aim to improve morality in society? Since 2008, moral bioenhancement (MBE), has received considerable attention in bioethics, generating wide scholarly disagreement. However, reviews on the subject are few and either outdated or not structured in method. This paper addresses this gap by providing a scoping review of the last fifteen years of debate on MBE (from 2008 to 2022). To enhance clarity, we map the debate into three key areas: (...) the conceptual foundations of MBE (foundational questions), the practical feasibility of MBE (practical questions), and the normative legitimacy of MBE (normative questions). Beyond identifying specific research gaps within these domains, our analysis reveals a general lack of empirical evidence either supporting or opposing MBE, as well as a shift in the literature from a universal interpretation of MBE to a more pragmatic one, targeting specific groups. (shrink)

This article investigates a critical yet underexplored structural aspect of consciousness in the context of the practical ethics of neural organoid research: the unity of consciousness. We advocate for the necessity of the unified field, which has garnered substantial support from both philosophical and empirical standpoints, although the debate remains unresolved. We highlight the brainstem as a potential source of the unified conscious field, a structure already under scrutiny in neural organoid research in relation to conditions such as Parkinson’s disease (...) and post-COVID-19 syndromes. We argue that if unity is a necessary feature of consciousness, consciousness is contingent upon a specific biological system without which consciousness cannot arise, thereby narrowing the range of neural organoids of ethical concern. Furthermore, the transplantation of neural organoids into animals has emerged as a practical concern, with ethical implications varying based on the necessity of the unity of consciousness. We argue that transplantation evades a significant ethical dilemma if unity is necessary and if the organoids to be transplanted lack the neural basis for the unified field of consciousness. (shrink)

I would like to thank Sullivan-Bissett and Noordhof for their stimulating comments on my 2023 paper in Neuroethics. In this reply, I will (1) articulate some deeper disagreements that may underpin our disagreement on the nature of delusion, (2) clarify their misrepresentation of my previous arguments as a defence of the two-factor theory in particular, and (3) finally conduct a comparison between the Maherian one-factor theory and the two-factor theory, showing that the two-factor theory is better supported by evidence.

Conventional electroencephalography (EEG) rarely appears in neuroethical discussions, despite its widespread use in scientific research. This oversight is largely due to its (perceived) harmlessness. There is limited empirical data regarding harm caused by EEG, with concerns mostly confined to its therapeutic applications. The conditions of EEG experiments, however, may require participants to remain still in an enclosed space for extended periods and maintain prolonged attention on monotonous tasks, sometimes while avoiding blinking. To date, there is no evidence of the impact (...) of human electrophysiological research on psychological well-being. Could these demanding conditions impact participants’ well-being beyond the risk of physical harm? Our study represents the first dedicated investigation into this aspect. To assess changes in psychological well-being and contributing factors, we administered the Positive and Negative Affect Schedule (PANAS) to participants in three distinct electrophysiological experiments before the start of the preparation phase (pre-test) and again after the experiment concluded (post-test). Our findings indicate that participants experience significant changes in their affect from pre- to post-experiment, as measured by the PANAS. Specifically, there was a significant reduction in positive affect across the group, while changes in negative affect were not observed. Furthermore, our analysis revealed that the reduction in positive affect was significantly predicted by the duration of the experiment, identifying time as a crucial factor in the negative impact on participants' psychological well-being. (shrink)

Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat psychiatric conditions. For depression therapy, PEIs include both approved treatment modalities, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), and experimental neurotechnologies, such as deep brain stimulation (DBS) and adaptive brain implants (ABIs). We present results from a survey-based experiment in which members of four relevant stakeholder groups (psychiatrists, patients with depression, caregivers of adults with depression, and the general public) assessed whether treatment with one of (...) four PEIs (ECT, rTMS, DBS, or ABIs) was better or worse than living with treatment-resistant depression (TRD) and then provided a narrative explanation for their assessment. Overall, the prevalence of many narrative themes differed substantially by stakeholder group—with psychiatrists typically offering different reasons for their assessment than non-clinicians—but much less so by PEI modality. A large majority of all participants viewed their assigned PEI as better than living with TRD, with their reasons being a mix of positive views about the treatment and negative views about TRD. The minority of all participants who viewed their assigned PEI as worse than living with TRD tended to express negative affect toward it as well as emphasize its riskiness, negative side effects, and, to a lesser extent, its invasiveness. The richness of these narrative explanations enabled us to put in context and add depth to key patterns seen in recent survey-based research on PEIs. (shrink)

In this paper, I examine the connections between bipolar disorder and consent. I defend the view that many (although far from all) individuals with bipolar disorder are competent to consent to a wide variety of things when they are in a manic state.

As neuroethics continues to grow as an established discipline, it has been charged with not being sufficiently sensitive to the way in which the identification, conceptualization, and management of the ethical issues raised by neuroscience and its applications are shaped by local systems of knowledge and structures. Recently there have been calls for explicit recognition of the role played by local cultural contexts and for the development of cross‐cultural methodologies that can facilitate meaningful cultural engagement. In this article, we attempt (...) to fill this perceived gap by providing a culturally situated analysis of the practice of electroconvulsive therapy (ECT) in Argentina. ECT was introduced as a psychiatric treatment in Argentina in the 1930s but it is largely underutilized. While the use of ECT remains low in several countries, what makes the Argentinian case interesting is that the executive branch of government has taken a stance regarding both the scientific and moral appropriateness of ECT, recommending its prohibition. Here, we begin with a recent controversy over the use of ECT in Argentina and explain the legal recommendation to ban its application. Next, we offer an overview of some of the salient aspect of the international and local discussions on ECT. We argue that the governmental recommendation to ban the procedure should be rethought. While acknowledging the role that contexts and local conditions play in shaping the identification and assessment of the relevant ethical issues, we caution against using contextual and cultural considerations to avoid a necessary ethical debate on controversial issues. (shrink)

This essay engages with the (re)emergence of psychedelic medicine and the idea of psychedelics drugs and the experiences they induce as a developing therapeutic modality. It does so in the context of the provision of psychedelics to terminally ill patients experiencing existential distress as they approach the end of their lives. Reflecting on such suggestions facilitates an examination of a specific aspect of psychedelics and/ as medicine (or palliative care), namely questions of meaning and meaninglessness. Understood as impacting one’s ability (...) to make or _realise_ meaning in life, existential distress commonly entails a degree of demoralisation. In some cases, individuals can be thought of as inhabiting (and being inhabited by) a sense of meaninglessness. In contrast, the experiences psychedelics seem to induce are often imbued with a great deal of meaning, a sense of which seems to continue long after the psychoactive effects of such drugs have ceased. Whilst briefly considering whether or not meaning can properly be thought of as a matter for healthcare or a medical concern, this paper seeks to highlight some of the implications that the advent of psychedelic medicine might have. By way of a conclusion, I enjoin bioethics in recognising itself as a meaningful cultural discourse that is implicated in the future(s) of medicine, psychedelics and being human. (shrink)

Disorders of Consciousness (DoC) result in profound functional impairment, adversely affecting the lives of a predominantly younger patient population. Currently, effective treatment options for those who have reached chronicity (prolonged symptom duration over 4 weeks) are extremely limited, with the majority of such cases facing life-long dependence on carers and a poor quality of life. Here we briefly review the current evidence on caseload, diagnostic and management options in the United Kingdom (UK), United States of America (USA) and the European (...) Union (EU). We identify key differences as well as similarities in these approaches across respective healthcare systems, highlighting unmet needs in this population. We subsequently present past efforts and the most recent advances in the field of surgical modulation of consciousness through implantable neurostimulation systems. We examine the ethical dilemmas that such a treatment approach may pose, proposing mediating solutions and methodological adjustments to address these concerns. Overall, we argue that there is a strong case for the utilisation of deep brain stimulation (DBS) in the DoC patient cohort. This is based on both promising results of recent clinical trials as well as technological developments. We propose a revitalization of surgical neuromodulation for DoC with a multicenter, multidisciplinary approach and strict monitoring guidelines, in order to not only advance treatment options but also ensure the safeguarding of patients’ welfare and dignity. (shrink)

Interventions designed to promote perspective taking are increasingly prevalent in educational settings, and are also being considered for applications in other domains. Thus far, these perspective-taking interventions (PTIs) have largely escaped philosophical attention, however they are sometimes _prima facie_ morally problematic in at least two respects: they are neither transparent nor easy to resist. Nontransparent or hard-to-resist PTIs call for a moral defense and our primary aim in this paper is to provide such a defense. We offer two arguments for (...) the view that an exemplar PTI is morally permissible even though it is plausibly neither transparent nor easy to resist. The first argument appeals to an analogy between PTIs and permissible deceptive research practices. The second appeals to the way in which PTIs draw participants’ attention to their reasons for action. We also respond to the objection that, by imposing a particular conception of the good, PTIs violate liberal neutrality. (shrink)

A pressing worry in the ongoing neurorights debate is the language used to advocate for newly proposed rights. This paper addresses this concern by first examining the partial and ambiguous associations between mind reading and neurotechnology, often cited by advocates in support of the right to mental privacy. Secondly, it addresses the conceptual foundations of mind reading, distinguishing between natural, digital, and neurotechnological forms. These distinctions serve to highlight the normative parallels in privacy vulnerabilities between neurotechnology and other mind-reading methods, (...) with an emphasis on multimodal digital systems. I suggest that authentic safeguards for the mental realm demand an expansion of the protective ambit beyond brain-targeted devices to recognize the spectrum of mind-reading applications. Ultimately, this urges re-evaluation of the scope and justification of a right to mental privacy owing to the need for coherent frameworks in an increasingly interconnected digital landscape. (shrink)

Psychedelic experiences are often compared to “transformative experiences” due to their potential to change how people think and behave. This study empirically examines whether psychedelic experiences constitute transformative experiences. Given psychedelics’ prospective applications as treatments for mental health disorders, this study also explores neuroethical issues raised by the possibility of biomedically directed transformation—namely, consent and moral psychopharmacology. To achieve these aims, we used both inductive and deductive coding techniques to analyze transcripts from interviews with 26 participants in psychedelic retreats. Results (...) indicate that psychedelic experiences can constitute transformative experiences. Twenty participants reported experiences or insights that were seemingly inaccessible or impossible to attain if not for the psychoactive effects of psychedelics. All participants besides one reported some change in identity, values, beliefs, desires, and behavior—changes in behavior being the most common. Participants also reported feeling capable deciding to use psychedelics in part due to information seeking prior to their retreats. Finally, several participants reported an enhanced capacity for enacting changes in their lives. Our results underscore both the importance of subjective embodiment to transformation and the role of transformative agency in shaping outcomes of the psychedelic experience. We examine our results relative to neuroethical issues and advocate for centering the person in psychedelic research and neuroethical inquiry about psychedelics to avoid pitfalls associated with psychedelics’ potential as moral psychopharmacological agents. (shrink)

The responsibility gap, commonly described as a core challenge for the effective governance of, and trust in, AI and autonomous systems (AI/AS), is traditionally associated with a failure of the epistemic and/or the control condition of moral responsibility: the ability to know what we are doing and exercise competent control over this doing. Yet these two conditions are a red herring when it comes to understanding the responsibility challenges presented by AI/AS, since evidence from the cognitive sciences shows that individual (...) humans face very similar responsibility challenges with regard to these two conditions. While the problems of epistemic opacity and attenuated behaviour control are not unique to AI/AS technologies (though they can be exacerbated by them), we show that we can learn important lessons for AI/AS development and governance from how philosophers have recently revised the traditional concept of moral responsibility in response to these challenges to responsible human agency from the cognitive sciences. The resulting instrumentalist views of responsibility, which emphasize the forward-looking and flexible role of agency cultivation, hold considerable promise for integrating AI/AS into a healthy moral ecology. We note that there nevertheless is a gap in AI/AS responsibility that has yet to be extensively studied and addressed, one grounded in a relational asymmetry of vulnerability between human agents and sociotechnical systems like AI/AS. In the conclusion of this paper we note that attention to this vulnerability gap must inform and enable future attempts to construct trustworthy AI/AS systems and preserve the conditions for responsible human agency. (shrink)

Bernat argues for a unified brain-based determination of death (UBDD), noting that it “conceptually justifies” death determination both in Donation after Circulatory Determination of Death (DCDD) a...

The concept of mental privacy can be defined as the principle that subjects should have control over the access to their own neural data and to the information about the mental processes and states that can be obtained by analyzing it. Our aim is to contribute to the current debate on mental privacy by identifying the main positions, articulating key assumptions and addressing central arguments. First, we map the different positions found in current literature. We distinguish between those who dismiss (...) concerns about mental privacy and those who endorse them. In this latter group, we establish a further disagreement between conservative and liberal strategies to protect mental privacy. Then, we address the first discussion by articulating and criticizing different skeptical views on mental privacy. Finally, we try to identify what are the unique features of neural data and examine how they may be connected to the ways in which neurotechnological mindreading could put mental privacy at risk. We suggest that even if neural data is unique, it may not require new strategies to protect people from its misuse. However, identifying the special features and risks of neurotechnological mind-reading is necessary for the second discussion on mental privacy to properly take off. (shrink)

Tourette’s Syndrome can involve disruptive “ticcing” behavior. Past work suggests that people sometimes blame those making tics for such disruptions. In the current work, we examined how blame perceptions vary depending on the person’s obligation and capacity to refrain from ticcing. Across two studies, we manipulated whether a person ticced in a formal versus informal social situation (obligation), after a weak versus strong urge to tic (capacity). We assessed perceptions of blame, free will, and moral character. Blame increased with increasing (...) obligation and capacity, and perceptions of free will primarily increased with increasing capacity, with perceived obligation playing a smaller role. Moral character ratings were largely unaffected by the manipulations, but people rated the person higher in moral character when their perceived obligation and capacity were low. Generally, women, younger people, and people who knew someone with Tourette’s rated the person who ticced more positively. Overall, these results suggest that whereas blame is sensitive to a person’s obligation and capacity, these perceptions do not map cleanly onto moral character perceptions, in part perhaps due to reduced free will perceptions. Efforts to normalize tics may reduce the perceived obligation to refrain, thereby avoiding both the pitfalls of blaming people with Tourette’s or viewing them as lower in free will. (shrink)

With the rise of the scientific authority of neuroscience and recent neurotechnological advances, the understanding of the human being and its future is beginning to undergo a radical change. As a result, a normative and existential vacuum is opening and hopes as well as fears about the future are flourishing. Some philosophers are anticipating a broad neuroscientific disenchantment, sociocultural disruption and a new existential anxiety related to the clash of the neuroscientific and humanistic image of humans. Others are expecting the (...) technological and scientific developments to lead to human enhancement and existential emancipation. In the first part of this commentary, I outline these two contrasting responses to the rise of neurocentricism and non-anthropocentrism. In the second part, I argue that the divide between the old anthropocentric paradigm and the emerging neuroscientific is misconceived and that literature and fictional narrative are particularly illustrative of the possibility of integrating scientific materialism with humanism. I use the contemporary literary-philosophical work The Creative Act by Rick Rubin to show that humanist ideas can indeed cohere with anti-essentialist and neuroscientific notions of personal identity and self and how existential meaning and comfort can be found in a neuroscientifically and deterministically explained world. (shrink)

Illusionism is a revisionary view of consciousness, which denies the existence of the phenomenal properties traditionally thought to render experience conscious. The view has theoretical attractions, but some think it also has objectionable ethical implications. They take illusionists to be denying the existence of consciousness itself, or at least of the thing that gives consciousness its ethical value, and thus as undermining our established ethical attitudes. This article responds to this objection. I argue that, properly understood, illusionism neither denies the (...) existence of consciousness nor entails that consciousness does not ground ethical value. It merely offers a different account of what consciousness is and why it grounds ethical value. The article goes on to argue that the theoretical revision proposed by illusionists does have some indirect implications for our ethical attitudes but that these are wholly attractive and progressive ones. The illusionist perspective on consciousness promises to make ethical decision making easier and to extend the scope of our ethical concern. Illusionism is good news. (shrink)

Increasing evidence suggests that psychedelic experiences, undergone in controlled conditions, can have various durable psychological benefits. One such benefit is reductions in fear of death, which have been attested in both psychiatric patients and healthy people. This paper addresses the question: how, exactly, do psychedelic experiences reduce fear of death? It argues, against some prominent proposals, that they do so mainly by promoting non-physicalist metaphysical beliefs. This conclusion has implications for two broader debates: one about the mechanisms of psychedelic therapy, (...) and one about the potential non-medical uses of psychedelics for the alleviation of existential angst in psychiatrically healthy people. On the first count, the paper argues that the role of metaphysical belief change in fear of death supports the “Relaxed Beliefs Under Psychedelics” (REBUS) model of psychedelic therapy over alternative accounts. On the second count, the paper argues that the role of metaphysical belief change undermines the proposed use of psychedelics in the “neuroexistentialist” project of naturalizing spirituality. The best available evidence suggests that when psychedelic experiences reduce existential angst and restore a sense of meaning in life, they do so primarily by persuading people of the falsity of a broadly naturalistic worldview, and thus do not help reconcile people to the truth of such a worldview. (shrink)

Much neuroethics literature concludes with a set of normative recommendations. While these recommendations can be a helpful way of summarizing a proposal for a future direction, some have recently argued that ethics scholarship has devoted insufficient attention to considerations of audience and real-world applications. To date, however, while scholars have conducted topic analyses of neuroethics literature, to our knowledge no study has evaluated who neuroethics scholarship addresses and what it recommends. The objective of the present study therefore was to provide (...) a preliminary characterization of recommendations offered in neuroethics scholarship and an assessment of their target audiences. Rather than attempting to demarcate what constitutes “neuroethics scholarship,” we analyzed text that authors’ had self-identified as being neuroethics-related: abstracts presented at the International Neuroethics Society (INS) annual meetings and published as top abstracts in AJOB Neuroscience in the last decade (2011–2020). We found that a majority of abstracts utilized conceptual methods (62.2%) and provided conceptual recommendations (68%). Roughly 77% of all abstracts did not explicitly address a target audience, yet nearly all of these were implicitly directed at other scholars. The remainder specified a target audience of scholars (12.2%), regulators (6.7%), healthcare providers (6.7%) and industry (2.6%). Only a subset of abstracts provided practical or policy recommendations (19.7%). Of those, the majority (61.5%) did not specify a target audience. Among the subset with actionable recommendations, a clarification of target audience may help increase the impact. (shrink)

Unemployment rates among autistic people are high even among those with low-support needs. While a variety of measures is needed to address this problem, this article defends one that has not been defended in detail and that has profound implications for contemporary hiring practices. Building on empirical research showing that job interviews are a major contributor to autistic unemployment, it argues that such interviews should be abolished in many cases for autistic and non-autistic people alike.

Advances in neuroscience and other disciplines are producing large-scale brain data consisting of datasets from multiple organisms, disciplines, and jurisdictions in different formats. However, due to the lack of an international data governance framework brain data is currently being produced under various contextual ethical and legal principles which may influence key stakeholders involved in the generation, collection, processing and sharing of brain data thereby raising ethical and legal challenges. In addition, despite the demand for a brain data governance framework that (...) accounts for culture, there is a gap in empirical research and actions to understand how key stakeholders around the world view these issues using neuroscientists who are affected by these ethical and legal principles. Therefore, using the research question how do ethical and legal principles influence data governance in neuroscience? we attempt to understand the perceptions of key actors on the principles, issues and concerns that can arise from brain data research. We carried out interviews with 21 leading international neuroscientists. The analytical insights revealed key ethical and legal principles, areas of convergence, visibility, and the contextual issues and concerns that arise in brain data research around these principles. These issues and concerns circulate around intimately connected areas which include ethics, human rights, regulations, policies and guidelines, and participatory governance. Also, key contextual insights around animal research and ethics were identified. The research identifies key principles, issues, and concerns that need to be addressed in advancing the development of a framework for global brain data governance. By presenting contextual insights from neuroscientists across regions, the study contributes to informing discussions and shaping policies aimed at promoting responsible and ethical practices in brain data research. The research answers the call for a cross cultural study of global brain data governance and the results of the study will assist in understanding the issues and concerns that arise in brain data governance. (shrink)

What happens at the end of a clinical trial for an investigational neural implant? It may be surprising to learn how difficult it is to answer this question. While new trials are initiated with increasing regularity, relatively little consensus exists on how best to conduct them, and even less on how to ethically end them. The landscape of recent neural implant trials demonstrates wide variability of what happens to research participants after an neural implant trial ends. Some former research participants (...) continue to receive support for their devices (e.g., battery and component replacements, software updates, etc.). Others, when safe, have their neural implants removed through surgical explantation. Still others continue to live with a deactivated neural implant embedded in their body. In the United States, there are no uniform requirements to provide services, of any kind, after an neural implant study ends, and other nations are similarly facing this challenge. The existence of a post-trial gap in an expanding neural implant research ecosystem invites obvious questions: What is owed to neural implant research participants post-trial, and why has providing it been so difficult to accomplish in practice? To take a step forward on this difficult issue, we assembled one group of stakeholders – researchers funded for neuroethics grants by the National Institutes of Health – to explore possible starting points on one topic: ethical guidance for post-trial care of research participants in neural implant trials. Based on shared concerns discussed in the expert workshop the current paper is a call to action. It reports the key areas of convergence from the meeting and highlights important next steps towards developing much needed guidance. (shrink)

Most philosophers think that phenomenal consciousness underlies, or at any rate makes a large contribution, to moral considerability. This paper argues that many such accounts invoke question-begging arguments. Moreover, they’re unable to explain apparent differences in moral status across and within different species. In the light of these problems, I argue that we ought to take very seriously a view according to which moral considerability is grounded in functional properties. Phenomenal consciousness may be sufficient for having a moral value, but (...) it may not be necessary, and it may contribute relatively little to our overall considerability. (shrink)

Alongside in vitro studies, researchers are increasingly exploring the transplantation of human brain organoids (HBOs) into non-human animals to study brain development, disease, and repair. This paper focuses on ethical issues raised by such transplantation studies. In particular, it investigates the possibility that they might yield enhanced brain function in recipient animals (especially non-human primates), thereby fundamentally altering their moral status. I assess the critique, raised by major voices in the bioethics and science communities, according to which such concerns are (...) premature and misleading. I identify the assumptions underlying this skeptical critique, and mention some objections against them, followed by some possible replies. I proceed to argue that the skeptical position is ultimately implausible, because it presupposes an unreasonably high standard of full moral status. My argument appeals to David DeGrazia’s idea of a “borderline person”, and to the need for consistency with existing animal research regulations. I outline the practical implications of my view for the conduct of studies that might result in the development of full moral status in a transplanted animal. I also discuss some of the ethical implications of animal enhancement (particularly of rodents) below the threshold associated with full moral status. I conclude that far from being premature, further debate on these issues is urgently needed to help clarify the prospects that a neural chimera might attain full moral status in the foreseeable future, and the level of quality of life required to make it acceptable to knowingly create such a being via HBO transplantation. (shrink)

This short communication explores the idea of “stream of consciousness” and considers some of the ways in which scientific writing relies – even or perhaps especially insofar as it does not signal this fact – on the resources of literary language and literary thinking. Particular attention is given to notions of literal and figurative or metaphorical language, including “hydrological” and “ontic” metaphor. A crucial figure is simile (the “like”), discussed here in relation to the Thomas Nagel’s “What is it Like (...) to Be a Bat?”, Todd Feinberg and Jon Mallatt’s Consciousness Demystified, and Anil Seth’s Being You: A New Science of Consciousness. Neuroethics cannot restrict itself to the domain of technology and the human. The deconstruction of anthropocentrism, already underway in literary modernism, calls for responsibility in relation to non-human as well as human life-forms. Virginia Woolf’s Mrs Dalloway provides rich and multifarious resources for exploring these issues. Woolf’s novel is considered as a kind of literary water music, in which sense and feeling is not limited to the human, and distinctions between consciousness and the environment are susceptible to dissolution. Woolf’s work is concerned with a conception of stream of consciousness as telepathic fluidity, as “merging minds” but without restitution of the individual or collective. (shrink)

Despite its obvious advantages, the disruptive development of neurotechnology can pose risks to fundamental freedoms. In the context of such concerns, proposals have emerged in recent years either to design human rights de novo or to update the existing ones. These new rights in the age of neurotechnology are now widely referred to as “neurorights.” In parallel, there is a considerable amount of ongoing academic work related to updating the right to freedom of thought in order to include the protection (...) of “freedom of thinking” (i.e., freedom of thought itself) and not only its social manifestations. Neurorights such as cognitive liberty, free will, mental freedom, and mental self-determination come into play here. Importantly, freedom of thought has often been considered a prerequisite for all the other fundamental freedoms and rights. In any case, just as other rights require additional legal instruments to guarantee their compliance, substantial neurorights will probably require specific complementary developments in procedural law. In relation to this, there is a long tradition of habeas corpus as an emergency remedy to enforce the rights of a citizen against illegal or arbitrary detention. More recently, the habeas data writ has been proposed and admitted in certain countries to guarantee a person’s ownership of their personal data. In this article, we propose to expand this procedural apparatus by incorporating a third habeas, which we call habeas cogitationem: a writ aimed primarily at enforcing the right to freedom of thinking (and, subsidiarily, the rest of neurorights) against direct, harmful interferences in a person’s thought process by both public and private perpetrators. (shrink)

We thank all the thoughtful authors for their insightful comments. In this response, we try to address some of themes that emerged from the commentaries. We leave aside some of those comments that...

This issue’s target articles cover some of the most hotly debated topics in neuroethics: neurorights and the potential establishment of international governance frameworks for neurotechnology. The...

The potential to collect brain data more directly, with higher resolution, and in greater amounts has heightened worries about mental and brain privacy. In order to manage the risks to individuals posed by these privacy challenges, some have suggested codifying new privacy rights, including a right to “mental privacy.” In this paper, we consider these arguments and conclude that while neurotechnologies do raise significant privacy concerns, such concerns are—at least for now—no different from those raised by other well-understood data collection (...) technologies, such as gene sequencing tools and online surveillance. To better understand the privacy stakes of brain data, we suggest the use of a conceptual framework from information ethics, Helen Nissenbaum’s “contextual integrity” theory. To illustrate the importance of context, we examine neurotechnologies and the information flows they produce in three familiar contexts—healthcare and medical research, criminal justice, and consumer marketing. We argue that by emphasizing what is distinct about brain privacy issues, rather than what they share with other data privacy concerns, risks weakening broader efforts to enact more robust privacy law and policy. (shrink)

Chenwei Nie ([22]) argues against a Maherian one-factor approach to explaining delusion. We argue that his objections fail. They are largely based on a mistaken understanding of the approach (as committed to the claim that anomalous experience is sufficient for delusion). Where they are not so based, they instead rest on misinterpretation of recent defences of the position, and an underestimation of the resources available to the one-factor theory.

Advances in neuroscience have enabled the transition of transcranial direct current stimulation (tDCS) from research and clinical settings to public use. For this primarily home-based context, tDCS has been popularized as a do-it-yourself (DIY) approach to improved cognition and wellness. The line between wellness and health is blurry, however, and little is known about how engagement with therapeutic tDCS impacts users’ interactions with other interventions such as clinical consultations, pharmacotherapy, complementary medicine, and even other neurotechnology. To close this gap, we (...) collected data from the online content aggregator Reddit and analyzed posts pertaining to tDCS. Findings indicate that most users turn to Reddit to request information about tDCS as an adjunct, but not as a bypass, to ongoing or prior approaches. Posts suggest that mainstream medical care is viewed as necessary but not sufficient to address conditions such as depression and anxiety. Users discuss a mix of benefits and harms. This discourse provides valuable insights into the health practices, concerns and priorities of users, and new knowledge for informing applications of neurotechnology both inside and outside the therapeutic setting. (shrink)

This study adopted an empirical method to investigate lay people’s attitudes toward the bioethical issues of human-animal chimeric brains. The results of online surveys showed that (1) people did not entirely reject chimeric brain research, but showed slightly more negative responses than ordinary animal testing; and that (2) their ethical concerns arose in connection with the perception that chimerism in the brain would humanize the animal. This means that people’s psychology was consistent with the ethical argument that crossing the human-animal (...) boundary would bring moral confusion to our society. Meanwhile, it was not in line with another argument that moral status depended on having high capacities, and that chimerism would cause a problem if it enhanced animals’ capacities. Furthermore, this study analyzed additional psychological factors related to people’s moral judgment and the relationship among those factors. Several psychological factors, such as the perception that chimeric brain research is unnatural, were identified as mediating the relationship between perception of animal humanization and ethical concerns about creating and using chimeric brains. Introducing an empirical approach to the ethics of human-animal chimeric brains brought two findings: (1) this study informed us of socially shared intuition regarding this novel technology; and (2) it unveiled the psychological processes behind people’s ethical concerns in more detail than they spontaneously mentioned. These findings will help to build normative arguments and future policies that are understandable and acceptable to society. (shrink)

In the historical context of a crisis in biological psychiatry, psychedelic drugs paired with psychotherapy are globally re-emerging in research clinics as a potential transdiagnostic therapy for treating mood disorders, addictions, and other forms of psychological distress. The treatments are poised to soon shift from clinical trials to widespread service delivery in places like Australia, North America, and Europe, which has prompted ethical questions by social scientists and bioethicists. Taking a broader view, we argue that the ethics of psychedelic therapy (...) concerns not simply how psychotherapies are different when paired with psychedelic drugs, but how psychedelic therapies shape and are shaped by different values, norms, and metaphysical commitments. Drawing from the published literature and interviews with seven psychedelic therapists working in clinical trials in the United States, Germany, Switzerland, and Australia, this article opens the black box of the treatments to consider the values and informal debates currently animating the therapies. Considering questions of patient autonomy, mechanisms of therapeutic action, and which therapies are best suited to pair with psychedelic substances, we examine the ethics of psychedelic therapy as an emergent form of life. To bring this form of life out in fuller relief, we conclude by comparing and contrasting it with ayahuasca use in Amazonian shamanism. (shrink)

Neural organoids are laboratory-generated entities that replicate certain structural and functional features of the human brain. Most neural organoids are disembodied—completely decoupled from sensory input and motor output. As such, questions about their potential capacity for consciousness are exceptionally difficult to answer. While not disputing the need for caution regarding certain neural organoid types, this paper appeals to two broad constraints on any adequate theory of consciousness—the first involving the dependence of consciousness on embodiment; the second involving the dependence of (...) consciousness on representations—to argue that disembodied neural organoids are not plausible candidates for consciousness. (shrink)

Environmental ethicists and experts in human health have raised concerns about the effects of hydraulic fracking to access natural oil and gas resources found deep in shale rock formations on surrounding ecosystems and communities. In this study, we analyzed the prevalence of discourse on brain and mental health, and ethics, in the peer-reviewed and grey literature in the five-year period between 2016 and 2022. A total of 84 articles met inclusion criteria for analysis. Seventy-six percent (76%) mentioned impacts on brain (...) (e.g., neural tube defects, neurological symptoms), and mental health (e.g., negative psychological effects, stress, depression) briefly; 11 reports dedicated substantive discourse to either or both together. References to safety (77%) dominated the ethics context. Discussion of environmental injustices as fracking sites disproportionately affect vulnerable communities appeared in 38% of the papers. We examine the findings through the lens of environmental neuroethics that brings human-made changes to the environment, brain and mental health, and ethics together into three interwoven lines of inquiry. (shrink)

A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials is growing steadily, and some countries already grant psychiatrists special permission to use psychedelics in non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing ethical question involves whether patients can even give informed consent to psychedelic-assisted therapy: the treatment’s transformative nature seems to block its assessment, suggesting that patients are unable to understand what undergoing psychedelic-assisted therapy actually (...) means for them and whether it aligns with their values. The present paper argues that patients often have sufficient knowledge to give informed consent because they know that they want to change their negative status quo and that psychedelic-assisted therapy offers an effective way to do so. Accordingly, patients can understand what the transformative nature of psychedelic-assisted therapy means for them and a make a value-aligned choice even if they are unable to anticipate the manifestation of a psychedelic experience. (shrink)

Mental health-related data generated by app users during the routine use of Consumer Mental Health Apps (CMHAs) are being increasingly leveraged for research and product improvement studies. However, it remains unclear which ethical safeguards and practices should be implemented by researchers and app developers to protect users during these studies, and concerns have been raised over their current implementation in CMHAs. To better understand which ethical safeguards and practices are implemented, why and how, 17 app developers and researchers were interviewed (...) who had been involved in using CMHA data for studies. Interviewees discussed the impact on stakeholder interests, sufficiency thresholds and procedural alterations of informed consent, data protection, gathering app user perspectives and representing users in app design and study conduct, and ensuring adequate support. Although the reasoning behind how and why these ethical safeguards and practices should be implemented showed considerable variability and several gaps, interviewees converged on various general lines of reasoning. This allowed for the development of a coherent and nuanced account that could prove useful for future CMHA studies and which could stimulate further normative investigation of the role of ethical safeguards and practices in these studies. (shrink)

Any attempt at consciousness assessment in organoids requires careful consideration of the theory of consciousness that researchers will rely on when performing this task. In cognitive neuroscience and the clinic, there are tools and theories used to detect and measure consciousness, typically in human beings, but none of them is neither fully consensual nor fit for the biological characteristics of organoids. I discuss the existing attempt relying on the Integrated Information Theory and its models and tools. Then, I revive the (...) distinction between global theories of consciousness and local theories of consciousness as a thought-provoking one for those engaged in the difficult task of adapting models of consciousness to the biological reality of brain organoids. The “microconsciousness theory” of Semir Zeki is taken as an exploratory path and illustration of a theory defending that minimal networks can support a form of consciousness. I suggest that the skepticism prevailing in the neuroscience community regarding the possibility of organoid consciousness relies on some assumptions related to a globalist account of consciousness and that other accounts are worth exploring at this stage. (shrink)

Depression is a widespread concern in the United States. Neuromodulation treatments are becoming more common but there is emerging concern for racial disparities in neuromodulation treatment utilization. This study focuses on Transcranial Magnetic Stimulation (TMS), a treatment for depression, and the structural and attitudinal barriers that racialized individuals face in accessing it. In January 2023 participants from the Twin Cities, Minnesota engaged in focus groups, coupled with an educational video intervention. Individuals self identified as non-white who had no previous TMS (...) exposure but had tried at least one treatment for their depression. Results revealed that the intervention did not notably change knowledge or stigma about TMS, but attitudes surrounding traveling for treatment changed. Notably, barriers like affordability, frequency of treatment, and lack of knowledge persist. Participants expressed a desire for more information, personal connection, and a tailored educational approach. The study suggests a need for multifaceted strategies to reduce disparities, focusing on education, community-based resources, and policy interventions. Immediate actions that can be taken include the creation of a TMS education program focused on patient engagement and awareness about TMS. (shrink)

Behaviorally assessing residual consciousness of acutely comatose patients involves a high rate of false-negatives. That is, long-term behavioral assessment shows that 41% of vegetative state patients in fact have residual consciousness. Nonetheless, surrogates need to remove ventilation before the acute-phase passes away if they want to induce medico-legal death due to pragmatic factors, such as financial costs. So, surrogate decision-making regarding behaviorally nonresponsive acutely comatose patients involves a moral dilemma: should we ignore the chance that patients have residual consciousness for (...) the sake of pragmatic factors? This paper examines whether neural methods can resolve the moral dilemma. Neural methods are used to assess residual consciousness of behaviorally nonresponsive postcomatose patients. For instance, by instructing a vegetative state patient to imagine wiggling all of her toes, conscious- ness is ascribed if brain activities are localized in the supplementary motor area. Since the most extensive application of neural methods has been in chronic population, it is unclear whether such methods can resolve the moral dilemma. I argue that neural methods also involve a high rate of false-negatives because current tasks of neural methods are structurally misguided. Given the argument, there is no significant difference between behavioral and neural methods regarding the moral dilemma. (shrink)

Brain Organoids in their current state of development are patentable. Future brain organoids may face some challenges in this regard, which I address in this contribution. Brain organoids unproblematically fulfil the general prerequisites of patentability set forth in Art. 3 (1) EU-Directive 98/44/ec (invention, novelty, inventive step and susceptibility of industrial application). Patentability is excluded if an invention makes use of human embryos or constitutes a stage of the human body in the individual phases of its formation and development. Both (...) do not apply to brain organoids, unless ES-cells are used. Art. 6 (1) EU-Directive 98/44/ec excludes patentability for inventions “the commercial exploitation of which would be contrary to ordre public or morality”. While there is no conceivable scenario, in which the commercial application of current brain organoids violates the ordre public, the same is not necessarily true for future brain organoids. Keeping in mind that a development of consciousness-like abilities in future brain organoids cannot be excluded and that an ability for both physical and psychological suffering has been theorized, both of which are aspects of the ordre public, certain applications of future brain organoids may constitute a violation of the ordre public and therefore lead to an exclusion of patentability. (shrink)

This Element offers a framework for exploring the methodological challenges of neuroethics. The aim is to provide a roadmap for the methodological assumptions, and related pitfalls, involved in the interdisciplinary investigation of the ethical and legal implications of neuroscientific research and technology. It illustrates these points via the debate about the ethical and legal responsibility of psychopaths. Argument and the conceptual analysis of normative concepts such as 'personhood' or 'human agency' is central to neuroethics. This Element discusses different approaches to (...) establishing norms and principles that regulate the practices addressed by neuroethics and that involve the use of such concepts. How to characterize the psychological features central to neuroethics, such as autonomy, consent, moral understanding, moral motivation, and control is a methodological challenge. In addition, there are epistemic challenges when determining the validity of neuroscientific evidence. (shrink)

The practice of medicine frequently involves the unconsented restriction of liberty. The reasons for unilateral liberty restrictions are typically that being confined, strapped down, or sedated are necessary to prevent the person from harming themselves or others. In this paper, we target the ethics of chemical restraints, which are medications that are used to intentionally restrict the mental states associated with the unwanted behaviors, and are typically not specifically indicated for the condition for which the patient is being treated. Specifically, (...) we aim to identify the conditions under which chemical restraints are ethically permissible. It is wrong to assume that what is morally true of physical restraints is also true of chemical restraints. Our aim is thus to identify the conditions under which chemical restraints are permissible while distinguishing these conditions from those of the application of physical restraints. (shrink)

Drawing from the literatures on the ethics of nudging and moral bioenhancement, I elaborate several pairs of cases in which one intervention is classified as an environmental behavioral intervention (EBI) and the other as a neurochemical behavioral intervention (NBI) in order to morally compare them. The intuition held by most is that NBIs are by far the more morally troubling kind of influence. However, if this intuition cannot be vindicated, we should at least entertain the _Similarity Thesis_, according to which (...) EBIs and NBIs share relevant moral features to the extent that moral conclusions about one are implied about the other in the described pairs of cases. I test this thesis by putting forward a number of possible moral grounds for setting EBIs and NBIs apart, including three of the most promising ones – physical invasiveness, disclosure and avoidance, and inevitability. I conclude that although these promising grounds might not bear the full burden of vindicating the intuition against _Similarity_ by themselves, clustering them together can establish discernible moral separation. (shrink)

Advocates of the Person-Centered Healthcare (PCH) approach say that PCH is a response to a failure of caring for patients as persons. Nevertheless, there are many human subjects falling to fulfill the requirements of a traditional philosophical definition of personhood. Hence, if we take, PCH seriously, a greater clarification of the key terminology of PCH is urgently needed. It seems necessary, for instance, that the concept of the person should be extended in order to include those individuals with insipient or (...) immature levels of consciousness, as well as those who are severely and permanently mentally handicapped. In this article, we will depart from some well-known philosophical concepts of what it means to be a person and try to offer a broader and more inclusive meaning. We suggest that persons are human beings with a socially recognized biography, which implies to recognize as persons individuals with necessities, but also with narratives about their interests and claims, expressed sometimes by other people related to them. This is particularly the case of individuals that suffer from severe disorders of consciousness. For those, is not only care that matters; respect matters too. Caregivers should therefore not only sympathetically care for the well-being of these people; they should also be concerned to respect their interests and claims by interpreting them empathetically, in the light of their biographical story. Our conclusion is that, in order to be coherent, PCH must consider individuals with severe disorders of consciousness as persons and we think that our revised concept of personhood fits with this requirement. (shrink)

Human brain organoids (HBOs) are novel entities that may exhibit unique forms of cognitive potential. What moral status, if any, do they have? Several authors propose that consciousness may hold the answer to this question. Others identify various _kinds of_ consciousness as crucially important for moral consideration, while leaving open the challenge of determining whether HBOs have them. This paper aims to make progress on these questions in two ways. First, it proposes a framework for thinking about the moral status (...) of entities other than paradigmatic persons. This framework identifies four qualities that ground moral status: evaluative stance, self-directedness, agency, and other-directedness. Second, we speculate on ways in which these qualities are relevant to dimensions of conscious experience that have been, or could be, identified in nonhuman animals. We further explore how these approaches could be adapted for use in HBOs, and argue that such studies, or something similar to them, will have to be performed if we wish to have empirical indications that HBOs have consciousness of a morally significant kind. We end by proposing that in our current scientific and epistemic situation, it is too soon to attribute any moral status to HBOs, but that this might change in the future. (shrink)

We explored the care experiences and needs of the home caregivers of patients with amyotrophic lateral sclerosis (ALS) to improve their quality of life. We interviewed home caregivers in-depth and analyzed the data using Colaizzi's descriptive phenomenological method. We interviewed 11 home caregivers of patients with ALS with a disease duration between 1.5 and 4 years. Primary caregivers were predominantly female and were the patients' spouses. Daily caregiving time averaged 4–14 h for 0.5–3.5 years. Interview themes included helplessness and adaptation (...) to life changes, hopelessness, compassion for the patient’s prognosis, and expectation for diverse support. The study sample size was limited, as all participants were from a single tertiary hospital, and all patients had severe functional impairment. Caregivers of patients with ALS experience a considerable burden. Patients and their caregivers can benefit from diversified support channels, and assistive communication systems can be applied to home care. Future research will focus on in-home public long-term care services in China. (shrink)