Neuroethics

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...

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)

Josh is a typical 27-year-old in a career that he enjoys and a successful marriage. Josh begins to exhibit the symptoms of a manic episode. He is soon diagnosed with bipolar disorder. While non-manic, Josh’s preferences are typical. While manic, his preferences change dramatically. He quits his job, cheats on his partner, and squanders his savings. These are behaviors that Josh, when non-manic (euthymic), would never agree to. When Josh returns to a euthymic state, he regrets these decisions. Should those (...) close to Josh have prevented him from making these decisions, or does his competence to decide persist despite his acute mania? In this paper, I examine the connections be-tween 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. This means that mania should not be presumed to undermine competence in clinical settings. -/- I have several goals in this paper. I want to bring philosophy to bear on the connection between consent and bipolar disorder. Additionally, I intend this paper to contribute to the general debate about the conditions of informed consent. Bipolar disorder presents novel challenges to existing conceptions of competence to consent which require stable core of values for an agent to be competent. For example, Buchanan and Brock endorse such a view. In showing that shifting values do not undermine the competence of a person experiencing acute mania, I show that the aforementioned views of competence are false. Overall, this paper makes substantive contributions to the debate about competence to consent and presents the first sustained philosophical treatment of consent among people with bipolar disorder. (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)

The ethical value—and to some scholars, necessity—of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status of psychedelics, the (...) nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association’s Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem. (shrink)

Advances in neurotechnologies, artificial intelligence (AI) and Big Data analytics are allowing interpretation of patterns from brain data to identify and even predict and manipulate mental states. Furthermore, there are avenues through which brain data can move into the consumer sphere, be reidentified and brokered. In response to these developments, there have been a number of approaches proposed to strengthen protections of brain data. To better understand the landscape of brain data protection discussions, we conducted a scoping review to identify (...) the rationales for establishing brain data protections and the proposals for protecting brain data offered in the ethics and neuroscience literature. To draw comparisons, we also surveyed the rationales given in the literature for the protection of sensitive behavioral inferences drawn from other types of personal data and associated approaches to achieving protection. This systematic examination of the rationale behind heightened protection for brain data should be useful to clarify the functional and conceptual bases given for brain data protection and to provide a better grounding for evaluating how the different approaches to brain data protection address these concerns. (shrink)

Should offenders with psychopathy or those exhibiting extreme forms of antisocial behav- iour be considered criminally responsible? The current debate seems to have reached a stalemate. Several scholars have argued that neuropsychologi- cal data on individuals with psychopathy might be relevant for determining their criminal responsibil- ity. However, relying on such data has not produced a consensus among legal scholars and philosophers on whether individuals with psychopathy should be excused from responsibility. We offer a diagnosis about why this debate has (...) reached a standoff. We argue that part of the problem is that psychopathy, being a syndrome-based category, is too heterogeneous and thus offers low prospects for being integrated with neuropsychological data that might support significant conclusions about the criminal responsibility of individuals with psychopathy. Moreover, the construct of psychopathy was not originally devised to discriminate criminally accountable from unac- countable antisocial individuals. To overcome these difficulties and advance the debate, we extend a currently less discussed theoretical framework for bridging biopsychology and the law that focuses on neuropsychological constructs, domains, and processes that directly measure capacities of offenders that are relevant for criminal responsibility, without necessarily relying on mediating syndrome-based constructs. The novelty of our contribution is that the biopsy- chological bases of exculpation can be further devel- oped and used for determining more fine-grained cat- egorisations of antisocial personality types. We show how this framework provides guidelines for inter- disciplinary research that can significantly advance our understanding of the preconditions for criminal responsibility and help the legal practice of ascribing or withholding it. (shrink)

Wexler and Sullivan (2023) recommend integration as a guiding principle for translational neuroethics. We agree that collaboration between neuroethicists and other professionals can advance the fie...

Human brain organoids (HCOs) are laboratory-grown biological entities that have been added to the catalog of living entities for just over a decade. How they are formed and may continue to develop for some time is not irrelevant, given their peculiarity, which is that they mimic the human brain with a high degree of similarity. Revolving around this key issue is the discussion on our target article (Zilio and Lavazza 2023), for which we are grateful to all the commentators.

The momentum for global neuroscience that is geopolitically-free has never been greater, and neuroethics holds a unique place in this context both in its translational and transnational forms.In th...

Today, nearly two years after Wexler and Sullivan’s (2023) article was first published, the crucial questions discussed therein are all the more pertinent and troubling. The advent of novel interve...

Wexler and Specker Sullivan (2023) note that, “unbridled speculation can imperil the credibility of neuroethics, generate unrealistic expectations amongst different stakeholders, take up time that...

Wexler and Specker (2023) offer a review of criticisms directed against what they describe as the relatively new field of neuroethics and offer as solution the development of a more “integrated, in...

Anna Wexler and Laura Specker Sullivan (2023) draw on their positionality as Global North early career neuroethics scholars to initiate a meaningful and timely conversation on Translational Neuroet...

Wexler and Specker Sullivan (2023) reflect on the field of neuroethics by highlighting criticisms from both scholars within and outside the field. Among these criticisms, are claims that neuroethic...

In their valuable call-for-action article, Wexler and Specker Sullivan (2023) propose an integration–inclusion–impact axis for “translational neuroethics,” to face the challenges and criticisms tha...

As early-career neuroethicists, we come to the field of neuroethics at a unique moment: we are well-situated to consider nearly two decades of neuroethics scholarship and identify challenges that have persisted across time. But we are also looking squarely ahead, embarking on the next generation of exciting and productive neuroethics scholarship. In this article, we both reflect backwards and turn our gaze forward. First, we highlight criticisms of neuroethics, both from scholars within the field and outside it, that have focused (...) on speculation and lack of skepticism; the dearth of consideration of broader social issues such as justice and equality, both with regard to who speaks for neuroethics as a field and who benefits from its recommendations and findings; and the insufficient focus on the practical impact of our ethical work. Second, we embrace the concept of “translational neuroethics” to outline a vision for neuroethics that is integrated, inclusive, and impactful. Integration can help us identify more pertinent, real-world issues, and move away from speculation; inclusivity can help ensure that the questions we attend to are not merely relevant to a single subgroup but aim toward just distribution of benefits; and impact can help us think beyond guidelines and recommendations to focus on implementation. Our goal is for this call to action to help shape neuroethics into a discipline that develops rigorous research agendas through relationships with interdisciplinary partners, that is broadly inclusive and attends to issues beyond novel neurotechnologies, and that is devoted to the translation of scholarship into practice. (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)

In this paper, we outline how one might conduct a comprehensive ethical evaluation of human brain organoid transplantation in animals. Thus far, ethical concerns regarding this type of research have been assumed to be similar to those associated with other transplants of human cells in animals, and have therefore not received significant attention. The focus has been only on the welfare, moral status, or mental capacities of the host animal. However, the transplantation of human brain organoids introduces several new ethical (...) issues. Many of these are related to uncertainty regarding whether or not brain organoids might be conscious. While these concerns might not be immediately relevant, they warrant closer scrutiny. We discuss how various ethical issues are relevant to different stages of human brain organoid transplantation and can guide the ethical evaluation of research. Our examination would broaden the horizons of the debate on the transplantation of brain organoids. (shrink)

This article investigates the challenges posed by the reliability of knowledge in neurophenomenology and its connection to reality. Neurophenomenological research seeks to understand the intricate relationship between human consciousness, cognition, and the underlying neural processes. However, the subjective nature of conscious experiences presents unique epistemic challenges in determining the reliability of the knowledge generated in this research. Personal factors such as beliefs, emotions, and cultural backgrounds influence subjective experiences, which vary from individual to individual. On the other hand, scientific knowledge (...) aims to uncover universal truths based on empirical observations and objective principles. Reconciling the subjective and objective realms presents a significant challenge in determining the reliability of knowledge generated through neurophenomenological research. This article aims to examine the inherent limitations and challenges of neurophenomenological research to shed light on the complexities involved in understanding the nature of knowledge itself. This article highlights that the ontological implications of the reliability of knowledge in neurophenomenology arise from the question of how subjective experiences relate to objective reality. Understanding the neural correlates and mechanisms behind subjective experiences can provide insight into the underlying ontological nature of consciousness. (shrink)

There is growing interest in the use of neurointerventions to reduce the risk that criminal offenders will reoffend. Commentators have raised several ethical concerns regarding this practice. One prominent concern is that, when imposed without the offender’s valid consent, neurointerventions might infringe offenders’ right to bodily integrity. While it is commonly held that we possess a moral right to bodily integrity, the extent to which this right would protect against such neurointerventions is as-yet unclear. In this paper, we will assess (...) whether, why, and how severely three forms of neurointervention might infringe the right to bodily integrity. We show that the severity of the infringement of the right to bodily integrity differs across different forms of neurointervention. Moreover, we argue that mental and behavioral effects of neurointerventions could in some cases be relevant to determining the severity of infringements of the right to bodily integrity. (shrink)

Brain age prediction is a relatively new tool in neuro-medicine and the neurosciences. In research and clinical practice, it finds multiple use as a marker for biological age, for general health status of the brain and as an indicator for several brain-based disorders. Its utility in all these tasks depends on detecting outliers and thus failing to correctly predict chronological age. The indicative value of brain age prediction is generated by the gap between a brain’s chronological age and the predicted (...) age, the brain age gap (BAG). This article shows how the clinical and research use of brain age prediction tacitly pathologizes the states that it is sensitive to. It will be argued that the tacit character of this transformation conceals the need for its explicit justification. (shrink)

Addiction is a common condition affecting millions of people worldwide of which only a small proportion receives treatment. The development and use of healthcare services is influenced by how addiction is understood (e.g., a condition to treat, a shameful condition to stigmatize), notably with respect to how volition is impacted (e.g., addiction as a choice or a disease beyond one’s control). Through semi-structured qualitative interviews, we explore the implicit views and understandings of addiction and volition across three stakeholder groups: people (...) with lived experience of addiction, clinicians with experience treating addiction, and members of the public without lived experience of addiction. We notably examine whether three paradigms, i.e., three philosophical sets of understandings about the nature of reality and knowledge (realism, relativism, pragmatism) reflect how stakeholders envision addiction and volition in the context of addiction. The use of these paradigms allows for the characterization of different stances on addiction and volition and an assessment of the coherence of beliefs about these matters. Our findings demonstrate that few participants relied on a single epistemic paradigm when describing their views. Furthermore, there were notable differences in understandings of volition between the clinician group, who were more oriented toward pragmatism, and people with lived experience of addiction, who were less oriented toward realism. Despite its limitations, our study suggests that a greater appreciation for the complexity of views held by different stakeholders about addiction and volition could help critically assess the search for coherence expressed in academic and policy debates. (shrink)

Advances in research on human cerebral organoids (HCOs) call for a critical review of current research policies. A challenge for the evaluation of necessary research regulations lies in the severe uncertainty about future trajectories the currently very rudimentary stages of neural cell cultures might take as the technology progresses. To gain insights into organotypic cultures, ethicists, legal scholars, and neuroscientists rely on resemblances to the human brain. They refer to similarities in structural or functional terms that have been established in (...) scientific practice to validate organotypic cultures as models for brain research. In ethical discourse, however, such similarities are also used to justify assumptions about the potential risk to cause harm to HCOs. Ethicists assume that as the technology advances, organotypic cultures will increasingly resemble the human brain, raising more complex ethical issues. I argue that such reasoning is not justified given the heterogeneity of HCOs that have been modified to enable scientists to pursue their research goals. I then discuss the implications this line of thought has for advocates of the precautionary principle, focussing on those suggestions which propose adopting research regulations to the presence of bodily warning signs deemed worthy of protection. In doing so, I illustrate that the prevalent assumptions on similarity in ethical discourse ultimately risk disproportionately restricting research. I conclude that given the severe uncertainty about the technology’s future development, ethical discourse might benefit from narrowing the time frame for anticipation. (shrink)

In the article “The Socio-Political Roles of Neuroethics and the Case of Klotho,” we proposed a socio-political approach to neuroethics, inspired by John Rawls’s roles for political philosophy. In...

From epileptic seizures to depressive symptoms, predictive neurotechnologies are used for a large range of applications. In this article we focus on advisory devices; namely, predictive neurotechnology programmed to detect specific neural events (e.g., epileptic seizure) and advise users to take necessary steps to reduce or avoid the impact of the forecasted neuroevent. Receiving advise from a predictive device is not without ethical concerns. The problem with predictive neural devices, in particular advisory ones, is the risk of seeing one’s autonomous (...) choice supplanted by the predictions instead of being supplemented by it. For users, there is a potential shift from being assisted by the system to being over-dependent on the technology. In other terms, it introduces ethical issues associated with epistemic dependency. In this article, we examine the notion of epistemic authority in relation to predictive neurotechnologies. Section 1 of our article explores and defines the concept of epistemic authority. In section 2, we illustrate how predictive devices are best conceived of as epistemic authorities and we explore the subject-device epistemic relationship. In section 3, we spell out the risk of harms interconnected with epistemic deferral. We conclude by stressing a set of preliminary measures to prepare users for the authoritative nature of predictive devices. (shrink)

Crutchfield (Crutchfield in Bioethics 33:112–121, [4]) has argued that if moral bioenhancement (MBE) ought to be compulsory, then it ought to be covert. More precisely, they argue that MBE is a public health intervention, and for this reason should be governed by public health ethics. Taking from various public health frameworks, Crutchfield provides an array of values to consider, such as: utility, liberty, equality, transparency, social trust, and autonomy. Subsequently, they argue that a covert MBE programme does better than an (...) overt one, in preserving or promoting said values, and hence, that a covert MBE is preferable. In this paper, I will provide novel reasons to doubt that the relevant values are in fact better promoted or preserved by a covert MBE programme. Additionally, I will provide a novel autonomy-based consideration which counts in favour of the MBE programme being overt, rather than covert. Given that as things currently stand it is unclear which kind of MBE programme is preferable, the upshot of my criticism of Crutchfield will be to provide some recommendations as to how we might proceed in establishing whether a covert or overt MBE programme fares better. (shrink)

The concept of mental integrity is currently a significant topic in discussions concerning the regulation of neurotechnologies. Technologies such as deep brain stimulation and brain-computer interfaces are believed to pose a unique threat to mental integrity, and some authors have advocated for a legal right to protect it. Despite this, there remains uncertainty about what mental integrity entails and why it is important. Various interpretations of the concept have been proposed, but the literature on the subject is inconclusive. Here we (...) consider a number of possible interpretations and argue that the most plausible one concerns neurotechnologies that bypass one’s reasoning capacities, and do so specifically in ways that reliably lead to alienation from one’s mental states. This narrows the scope of what constitutes a threat to mental integrity and offers a more precise role for the concept to play in the ethical evaluation of neurotechnologies. (shrink)

Objectives To characterize recruitment approaches to research on the brain and mind that involves Indigenous peoples. Methods We conducted a secondary analysis of a Harding et al. (2021) scoping review. Reviewers screened studies (_n_ = 66) for sampling methods, recruitment and engagement, positionality statements, and details on ethics approvals. Synthesis We identified twenty-nine (29) English-language articles relevant to the analysis. Of these, 52% (_n_ = 15/29) reported a mix of sampling methods; 45% (_n_ = 13/29) contained statements or information about (...) author positionalities. While, overall, 24% (_n_ = 7/29) of the studies were missing information about ethics protocols, we observe an improvement over time in the reporting of approvals and use of community-engaged participant recruitment methods. Current brain research studies demonstrate ways of collaborating with Indigenous communities that meet existing ethics guidelines. To be wholly responsive to the needs of Indigenous peoples, however, researchers may need to exceed existing ethical benchmarks.. Positionality statements successfully detailed the relationships of the research teams with the communities with which they work, and contextualized recruitment methods. Conclusion Improved quality and meaningfulness of brain research with Indigenous peoples and trust in the research process and public health will be enhanced when remaining gaps in protecting and reporting of participant recruitment methods are closed. (shrink)