Neuroethics, Misc

Cognitive enhancement may be defined as the amplification or extension of core capacities of the mind through improvement or augmentation of internal or external information processing systems. Cognition refers to the processes an organism uses to organize information. These include acquiring information (perception), selecting (attention), representing (understanding) and retaining (memory) information, and using it to guide behavior (reasoning and coordination of motor outputs). Interventions to improve cognitive function may be directed at any of these core faculties.

Interventions that modify a person’s motivations through chemically or physically influencing the brain seem morally objectionable, at least when they are performed nonconsensually. This chapter raises a puzzle for attempts to explain their objectionability. It first seeks to show that the objectionability of such interventions must be explained at least in part by reference to the sort of mental interference that they involve. It then argues that it is difficult to furnish an explanation of this sort. The difficulty is that (...) these interventions seem no more objectionable, in terms of the kind of mental interference that they involve, than certain forms of environmental influence that many would regard as morally innocuous. The argument proceeds by comparing a particular neurointervention with a comparable environmental intervention. The author argues, first, that the two dominant explanations for the objectionability of the neurointervention apply equally to the environmental intervention, and second, that the descriptive difference between the environmental intervention and the neurointervention that most plausibly grounds the putative moral difference in fact fails to do so. The author concludes by presenting a trilemma that falls out of the argument. (shrink)

This chapter reviews recent philosophical and neuroethical literature on the morality of moral neuroenhancements. It first briefly outlines the main moral arguments that have been made concerning moral status neuroenhancements. These are neurointerventions that would augment the moral status of human persons. It then surveys recent debate regarding moral desirability neuroenhancements: neurointerventions that augment that the moral desirability of human character traits, motives or conduct. This debate has contested, among other claims (i) Ingmar Persson and Julian Savulescu’s contention that there (...) is a moral imperative to pursue the development of moral desirability neuroenhancements, (ii) Thomas Douglas’ claim that voluntarily undergoing moral desirability neuroenhancements would often be morally permissible, and (iii) David DeGrazia’s claim that moral desirability neuroenhancements would often be morally desirable. The chapter discusses a number of concerns that have been raised regarding moral desirability neuroenhancements, including concerns that they would restrict freedom, would produce only a superficial kind of moral improvement, would rely on technologies that are liable to be misused, and would frequently misfire, resulting in moral deterioration rather than moral improvement. (shrink)

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

Background -/- Innovative neurosurgical treatments present a number of known risks, the natures and probabilities of which can be adequately communicated to patients via the standard procedures governing obtaining informed consent. However, due to their novelty, these treatments also come with unknown risks, which require an augmented approach to obtaining informed consent. -/- Objective -/- This paper aims to discuss and provide concrete procedural guidance on the ethical issues raised by serious unexpected complications of novel deep brain stimulation treatments. -/- (...) Approach -/- We illustrate our analysis using a case study of the unexpected development of recurrent stereotyped events in patients following the use of deep brain stimulation (DBS) to treat severe chronic pain. Examining these unexpected complications in light of medical ethical principles, we argue that serious complications of novel DBS treatments do not necessarily make it unethical to offer the intervention to eligible patients. However, the difficulty the clinician faces in determining whether the intervention is in the patient's best interests generates reasons to take extra steps to promote the autonomous decision making of these patients. -/- Conclusion and recommendations -/- We conclude with clinical recommendations, including details of an augmented consent process for novel DBS treatment. (shrink)

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

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

Discussion of the ethics of memory modification technologies (MMTs) has often focused on questions about the limits of their permissibility. In the current paper, I focus primarily on a different issue: when (if ever) is it rational to prefer MMTs to alternative interventions? The question is crucial. Unless those who condone the use of MMTs offer guidance for navigating among various interventions, their account risks becoming a moral endorsement that says little about what one faced with the option of using (...) an MMT should do. In this paper, I therefore consider questions about the conditions in which MMTs are rationally preferable to alternative interventions. My conclusion is that these conditions are rare. The reason stems from considerations of autonomy. When compared with other interventions, MMTs do a particularly poor job at promoting of their users. Insofar as a decision-maker values autonomy, this therefore counts against choosing MMTs over alternative interventions. If that is true, moreover, this provides a fresh perspective on debates about the permissibility MMTs. For those who would limit the use of MMTs to a narrow range of circumstances, the conclusion that MMTs are rarely preferable gives them further reason to eye MMTs with suspicion. For those who view MMTs as permissible in a wide range of circumstances, the conclusion may deflate their endorsement. By approaching MMTs from the perspective offered by questions about preferability, I therefore ultimately aim to focus discussions about MMTs on the subjective rationality rather than the moral permissibility of their usage. (shrink)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Technology could be used to improve morality but it could do so in different ways. Some technologies could augment and enhance moral behaviour externally by using external cues and signals to push and pull us towards morally appropriate behaviours. Other technologies could enhance moral behaviour internally by directly altering the way in which the brain captures and processes morally salient information or initiates moral action. The question is whether there is any reason to prefer one method over the other? In (...) this article, I argue that there is. Specifically, I argue that internal moral enhancement is likely to be preferable to external moral enhancement, when it comes to the legitimacy of political decision-making processes. In fact, I go further than this and argue that the increasingly dominant forms of external moral enhancement may already be posing a significant threat to political legitimacy, one that we should try to address. Consequently, research and development of internal moral enhancements should be prioritised as a political project. (shrink)

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

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

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

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

Scientists, engineers, and healthcare professionals are currently developing a variety of new devices under the category of brain-computer interfaces (BCIs). Current and future applications are both medical/assistive (e.g., for communication) and non-medical (e.g., for gaming). This array of possibilities comes with ethical challenges for all stakeholders. As a result, BCIs have been an object of both hope and concern in various media. We argue that these conflicting sentiments can be productively understood in terms of personhood, specifically the impact of BCIs (...) on what it means to be a person and to be recognized as such by others. To understand the dynamics of personhood in the context of BCI use and investigate whether ethical guidance is required, a meeting entitled "BCIs and Personhood: A Deliberative Workshop" was held in May 2018. In this article, we describe how BCIs raise important questions about personhood and propose recommendations for BCI development and governance. (shrink)

Modern neurotechnologies are rapidly infringing on conventional notions of human dignity and they are challenging what it means to be human. This article is a survey analysis of the future of the digital age, reflecting primarily on the effects of neurotechnology that violate universal human rights to dignity, self-determination, and privacy. In particular, this article focuses on neuromarketing to critically assess potentially negative social ramifications of under-regulated neurotechnological application. Possible solutions are critically evaluated, including the human rights claim to the (...) ‘right to mental privacy’ and the suggestion of a new human right based on spiritual jurisdiction, where the human psyche is a legal space in a substantive legal setting. (shrink)

The purpose of this paper is twofold. First, I defend and expand the Fortificationist Theory of Punishment. Second, I argue that this theory implies that non-consensual neurointerventions – interventions that act directly on one’s brain – are permissible. According to the FTP, punishment is justified as a way of ensuring that citizens who infringe their duty to demonstrate the reliability of their moral powers will thereafter be able to comply with it. I claim that the FTP ought to be expanded (...) to include citizens’ interest in developing their moral powers. Thus, states must ensure that their citizens develop their moral reliability, not only because they must enforce their citizens’ compliance with certain duties, but also because states have the duty to maintain the conditions for stability and satisfy their citizens’ interest in developing their moral powers. According to this account of the FTP, if neurointerventions are the only or best way of ensuring that offenders can discharge their fortificational duties, states have strong reasons to provide these interventions. (shrink)

Since its emergence in the early 2000s, neuroethics has become a recognized, institutionalized and professionalized field. A central strategy for its successful development has been the claim that it must be an autonomous discipline, distinct in particular from bioethics. Such claim has been justified by the conviction, sustained since the 1990s by the capabilities attributed to neuroimaging technologies, that somehow ‘the mind is the brain’, that the brain sciences can illuminate the full range of human experience and behavior, and that (...) neuroscientific knowledge will have dramatic implications for views of the human, and challenge supposedly established beliefs and practices in domains ranging from self and personhood to the political organization of society. This article examines how that conviction functions as neuroethics’ ideological condition of possibility. (shrink)

Traditional means of crime prevention, such as incarceration and psychological rehabilitation, are frequently ineffective. This collection considers how crime preventing neurointerventions could present a more humane alternative but, on the other hand, how neuroscientific developments and interventions may threaten fundamental human values.

Experimenters claim some nonhuman mammals have metacognition. If correct, the results indicate some animal minds are more complex than ordinarily presumed. However, some philosophers argue for a deflationary reading of metacognition experiments, suggesting that the results can be explained in first-order terms. We agree with the deflationary interpretation of the data but we argue that the metacognition research forces the need to recognize a heretofore underappreciated feature in the theory of animal minds, which we call Unity. The disparate mental states (...) of an animal must be unified if deflationary accounts of metacognition are to hold and untoward implications avoided. Furthermore, once Unity is acknowledged, the deflationary interpretation of the experiments reveals an elevated moral standing for the nonhumans in question. (shrink)

Birks and Buyx (2018) claim that, at least in the foreseeable future, nonconsensual neurointerventions will almost certainly suppress some valuable mental states and will thereby impose an objectionable harm to mental integrity—a harm that it is pro tanto wrong to impose. Of course, incarceration also interferes with valuable mental states, so might seem to be objectionable in the same way. However, Birks and Buyx block this result by maintaining that the negative mental effects of incarceration are merely foreseen, whereas those (...) of neurointerventions are intended. We dispute Birks and Buyx’s characterization of the descriptive difference between these effects. In both cases, the negative effects are caused, not constituted, by the act in question. (shrink)

The cases that Doris chronicles of confabulation are similar to perceptual illusions in that, while they show the interstices of our perceptual or cognitive system, they fail to establish that our everyday perception or cognition is not for the most part correct. Doris's account in general lacks the resources to make synchronic assessments of responsibility, partially because it fails to make use of knowledge now available to us about what is happening in the brains of agents.

At the present time there is a boom in the use of pharmacological cognitive enhancers (PCEs) particularly within an academic and labor context. Numerous objections to the use of this medicines arise in the context of Neuroethics, being one of the most important, the principle of justice. Among the most prevalent arguments put forward it is noted the disturbance of distributive justice and competitive fairness. -/- Succinctly it is established that hypothetical PCEs without adverse effects could promote the social fragmentation (...) by favoring economically dominant classes. However, it has been experimentally observed that PCEs present benefits ruled by the inverted U phenomenon, where cognitive benefits given by these medicines are not dose-dependent and have dependence on the baseline performance. Producing bigger benefits in individuals that initially had a worst performance. In this way the use of PCEs, assuming a context of open-access, could contribute to social equity and distributive justice. (shrink)

The use of cognition-enhancing drugs is a topic that currently requires special attention, particularly given the growing patient demand for their prescription. It is essential to examine the ethical aspects inherent to the use of these drugs, especially when they are not an innocuous intervention. -/- The effectiveness of these cognition-enhancing drugs lacks the scientific evidence that supports the benefits attributed to them, such as more focus or better memory, as the results in studies show little consistency covering a spectrum (...) from deleterious effects to beneficial effects in certain tasks. -/- Considering this background, it is obvious that an assessment is required on how ethical it is to prescribe or recommend them. This assessment can be made based on bioethical principles of non-maleficence, beneficence, autonomy, and justice. Non-maleficence is a concern when reviewing potential adverse effects. Beneficence is unclear, particularly when it is doubtful that the benefits shown in some studies translate into improved performance in the real world. Although the current effectiveness of cognition-enhancing drugs suggests that they do not pose a problem to the justice principle, this should not be an aspect to be dismissed considering that this may change with the development of more effective cognition-enhancing drugs. (shrink)

ZusammenfassungFünfzehn Jahre nach ihrer Entstehung ist die Neuroethik ein internationales wissenschaftliches Feld mit enormer Dynamik. Innerhalb weniger Jahre wurden eigene Kongresse, Zeitschriften, Forschungsförderprogramme, Fachgesellschaften und Institute gegründet. Gleichwohl besteht erheblicher Dissens über die Definition und den Gegenstandsbereich dieses neuen Gebiets. Wir argumentieren hier für eine differenzierte Konzeption, wonach neben der Reflexion ethischer Probleme der Neurowissenschaft und ihrer überwiegend neurotechnologischen Anwendungen auch die ethische Reflexion neurowissenschaftlicher Forschung zur Moralität zur Neuroethik gehört. Dies umfasst zwar nicht neurowissenschaftliche oder neuropsychologische Studien zur Moralität, (...) wohl aber die Reflexion der Bedeutung dieser Forschung für die Ethik und das Recht. Wir geben einen Überblick über die wichtigsten Themen der Neuroethik, woraus deutlich wird, wie sehr in verschiedenen gesellschaftlichen Bereichen, auch jenseits von Medizin und Gesundheitswesen, neuroethische Fragen relevant sind. Das Potenzial der Neuroethik als eines neuen Wissenschaftsfeldes liegt darin, durch eine Verknüpfung neurophilosophischer und medizinethischer Themen sowie eine breite interdisziplinäre Vernetzung neue Antworten auf gesellschaftlich drängende Fragen zu finden. (shrink)

Common understandings of neuroethics, i.e., of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics; (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism while the second relies on debatable assumptions about (...) the nature of bioethics specialization and development. Informed by philosophical pragmatism and our experience in neuroethics, we argue that these claims are ill-founded and should give way to pragmatist reconstructions. Namely, neuroscience, much like other areas of empirical research on morality, can provide useful information about the nature of morally problematic situations but it does not need to promise radical and sweeping changes to ethics based on neuroscientism. Furthermore, the rationale for the development of neuroethics as a specialized field need not to be premised on the distinctive nature of the issues it tackles or of neurotechnologies. Rather, it can espouse an understanding of neuroethics as both a scholarly and a practical endeavor dedicated to resolving a series of problematic situations raised by neurological and psychiatric conditions. (shrink)

This article clarifies what a neuroscience challenge to criminal justice must look like by sketching the basic structure of the argument, gradually filling out the details and illustrating the conditions that must be met for the challenge to work. In the process of doing so it explores influential work by Joshua Greene and Jonathan Cohen, and Stephen Morse respectively, arguing that the former should not be understood to present a version of the challenge, and that the latter's argument against the (...) challenge is unpersuasive. This analysis allows the article to flesh out the challenge, and demonstrate why it is currently non-completeable. However, the paper argues that contrary to what is often assumed the burden of proof falls on the defenders of criminal justice, and that they will find meeting it a monumental task. (shrink)

Patients in a minimally conscious state (MCS) fall into a different diagnostic category than patients in the more familiar vegetative states (VS). Not only are MCS patients conscious in some sense, they have a higher chance for recovery than VS patients. Because of these differences, we ostensibly have reason to provide MCS patients with care that goes beyond what we provide to patients with some VS patients. But how to justify this differential treatment? I argue we can’t justify it solely (...) by looking to MCS patients’ actual levels of consciousness. We must look also to the ways in which these patients are potentially conscious. Specifically, I argue that certain sensible and well-regarded policy recommendations cannot be justified by looking solely to patients’ actual levels of consciousness, but that they can be justified by looking to patients’ potential for consciousness. Insofar then as we have prima facie reason to follow the recommendations, we also have prima facie reason to view the potential for consciousness as morally salient. If that is true, however, several important implications follow: first, if the potential for consciousness is morally salient, this translates into actual and pressing obligations to patients with disorders of consciousness generally. Second, if the potential for consciousness is morally salient, this has implications that go beyond our obligations to patients with disorders of consciousness. Indeed, if the potential for consciousness is morally salient, this adds an important layer of complexity to the normative landscape, a layer we may not have sufficiently noticed before. (shrink)