This chapter addresses the claim that, as new types of neurointervention get developed allowing us to enhance various aspects of our mental functioning, we should work to prevent the use of such interventions from ever becoming the “new normal,” that is, a practice expected—even if not directly required—by employers. The author’s response to that claim is that, unlike compulsion or most cases of direct coercion, indirect coercion to use such neurointerventions is, per se, no more problematic than the pressure people (...) all find themselves under to use modern technological devices like computers or mobile phones. Few people seem to believe that special protections should be introduced to protect contemporary Neo-Luddites from such pressures. That being said, the author acknowledges that separate factors, when present, can indeed render indirect coercion to enhance problematic. The factors in question include lack of safety, fostering adaptation to oppressive circumstances, and having negative side effects that go beyond health. Nonetheless, the chapter stresses that these factors do not seem to be necessary correlates of neuroenhancement. (shrink)

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

ZusammenfassungMedizinethische Untersuchungen zum Thema Neuroenhancement (NE) wenden sich oft der Frage zu, inwiefern der Einzelne wie auch die Allgemeinheit durch NE zu Schaden kommen können. Gerechtigkeitsprobleme, ein befürchteter Wandel des Menschenbildes oder die Gefahr einer unerwünschten, schleichenden Veränderung der Gesellschaft werden problematisiert. Bezüglich individueller Risiken bleibt es aufgrund des vermeintlichen Zugewinns an Selbstbestimmung und Eigenverantwortung gerne beim Verweis auf die subjektive Kosten-Nutzen-Abwägung. Innerhalb der NE-Debatte gibt es bisher kaum Arbeiten, die die Aspekte der Motivation für die Nutzung von NE aus (...) tiefenpsychologischer Perspektive beleuchten. Das Ziel der vorliegenden Arbeit ist es, diese Aspekte zu analysieren. Die Arbeit soll einen Beitrag zu einem neuen Blickwinkel auf Selbstbestimmung und subjektive Einschätzung der Vor- und Nachteile von NE leisten. Es werden psychologische Aspekte thematisiert, welche die im Kontext von NE übliche Annahme, dass Konsumenten zur Selbstverantwortung fähig seien, problematisch erscheinen lassen, da sie die Wahrnehmung dieser Verantwortung erschweren oder gar unmöglich machen können. In diesem Zusammenhang wollen wir versuchen, für die psychologischen Gefahren und Folgen von NE zu sensibilisieren. Es wird beispielsweise darüber diskutiert, inwiefern der Gebrauch von NE-Technologien eine Persönlichkeit nachhaltig prägen und gerade deshalb das Erleben von Selbstwirksamkeit beeinträchtigen kann. Dies stellt die für die liberale Position zentrale Prämisse, wonach Individuen sich frei und vernünftig entscheiden können, infrage. (shrink)

Medizinethische Untersuchungen zum Thema Neuroenhancement (NE) wenden sich oft der Frage zu, inwiefern der Einzelne wie auch die Allgemeinheit durch NE zu Schaden kommen können. Gerechtigkeitsprobleme, ein befürchteter Wandel des Menschenbildes oder die Gefahr einer unerwünschten, schleichenden Veränderung der Gesellschaft werden problematisiert. Bezüglich individueller Risiken bleibt es aufgrund des vermeintlichen Zugewinns an Selbstbestimmung und Eigenverantwortung gerne beim Verweis auf die subjektive Kosten-Nutzen-Abwägung. Innerhalb der NE-Debatte gibt es bisher kaum Arbeiten, die die Aspekte der Motivation für die Nutzung von NE aus (...) tiefenpsychologischer Perspektive beleuchten. Das Ziel der vorliegenden Arbeit ist es, diese Aspekte zu analysieren. Die Arbeit soll einen Beitrag zu einem neuen Blickwinkel auf Selbstbestimmung und subjektive Einschätzung der Vor- und Nachteile von NE leisten. Es werden psychologische Aspekte thematisiert, welche die im Kontext von NE übliche Annahme, dass Konsumenten zur Selbstverantwortung fähig seien, problematisch erscheinen lassen, da sie die Wahrnehmung dieser Verantwortung erschweren oder gar unmöglich machen können. In diesem Zusammenhang wollen wir versuchen, für die psychologischen Gefahren und Folgen von NE zu sensibilisieren. Es wird beispielsweise darüber diskutiert, inwiefern der Gebrauch von NE-Technologien eine Persönlichkeit nachhaltig prägen und gerade deshalb das Erleben von Selbstwirksamkeit beeinträchtigen kann. Dies stellt die für die liberale Position zentrale Prämisse, wonach Individuen sich frei und vernünftig entscheiden können, infrage. (shrink)

Detection of deception and confirmation of truth telling with conventional polygraphy raised a host of technical and ethical issues. Recently, newer methods of recording electromagnetic signals from the brain show promise in permitting the detection of deception or truth telling. Some are even being promoted as more accurate than conventional polygraphy. While the new technologies raise issues of personal privacy, acceptable forensic application, and other social issues, the focus of this paper is the technical limitations of the developing technology. Those (...) limitations include the measurement validity of the new technologies, which remains largely unknown. Another set of questions pertains to the psychological paradigms used to model or constrain the target behavior. Finally, there is little standardization in the field, and the vulnerability of the techniques to countermeasures is unknown. Premature application of these technologies outside of research settings should be resisted, and the social conversation about the appropriate parameters of its civil, forensic, and security use should begin. (shrink)

Direct brain intervention based mental capacity restoration techniques-for instance, psycho-active drugs-are sometimes used in criminal cases to promote the aims of justice. For instance, they might be used to restore a person's competence to stand trial in order to assess the degree of their responsibility for what they did, or to restore their competence for punishment so that we can hold them responsible for it. Some also suggest that such interventions might be used for therapy or reform in criminal legal (...) contexts-i.e. to make non-responsible and irresponsible people more responsible. However, I argue that such interventions may at least sometimes fail to promote these responsibility-related legal aims. This is because responsibility hinges on other factors than just what mental capacities a person has-in particular, it also hinges on such things as authenticity, personal identity, and mental capacity ownership-and some ways of restoring mental capacity may adversely affect these other factors. Put one way, my claim is that what might suffice for the restoration of competence need not necessarily suffice for the restoration of responsibility, or, put another way, that although responsibility indeed tracks mental capacity it may not always track restored mental capacities. (shrink)

The new field of neuroethics has recently emerged following unprecedented developments in the neurosciences. Neuroimaging and cognitive enhancement in particular are demanding ethical debate. For example, neuroscientists are able to measure, with increasing accuracy, intimate personal biases and thoughts as they occur in the brain. Smart drugs are now available that can effectively and safely enhance mental functioning in both healthy and clinical populations. This article describes the scientific principles behind these technologies, and urges the development of ethical principles based (...) on a clear understanding of them. Europe should take the United States’ lead in devoting resources specifically intended to examine neuroethical concerns within European healthcare and legal frameworks. (shrink)

Brain Computer Interfaces (BCIs) enable one to control peripheral ICT and robotic devices by processing brain activity on-line. The potential usefulness of BCI systems, initially demonstrated in rehabilitation medicine, is now being explored in education, entertainment, intensive workflow monitoring, security, and training. Ethical issues arising in connection with these investigations are triaged taking into account technological imminence and pervasiveness of BCI technologies. By focussing on imminent technological developments, ethical reflection is informatively grounded into realistic protocols of brain-to-computer communication. In particular, (...) it is argued that human-machine adaptation and shared control distinctively shape autonomy and responsibility issues in current BCI interaction environments. Novel personhood issues are identified and analyzed too. These notably concern (i) the “sub-personal” use of human beings in BCI-enabled cooperative problem solving, and (ii) the pro-active protection of personal identity which BCI rehabilitation therapies may afford, in the light of so-called motor theories of thinking, for the benefit of patients affected by severe motor disabilities. (shrink)

Undergraduates (total N = 185) were asked about performance-affecting drugs. Some drugs supposedly affected athletic performance, others memory, and others attention. Some improved performance for anyone who took them, others for the top 10% of performers, others for the bottom 10%, and finally, yet other drugs worked only on the bottom 10% who also showed physical abnormalities. Participants were asked about the fairness of allowing the drug to be used, about banning it, and about whether predictions of future performance based (...) on testing with or without the drug were better. The study found that participants appreciated the "interaction effect", that they felt it was less unfair to allow the drug if it affected the bottom 10% than if it affected everyone, and they were more eager to have the drug banned if it affected everyone. Participants were least tolerant of drugs that affected athletic performance and most tolerant of those that affected attention. (shrink)

Whether it is morally acceptable to offer rehabilitation by CNS-intervention to criminals as a condition for early release constitutes an important neuroethical question. Bomann-Larsen has recently suggested that such interventions are unacceptable if the offered treatment is not narrowly targeted at the behaviour for which the criminal is convicted. In this article it is argued that Bomann-Larsen’s analysis of the morality of offers does not provide a solid base for this conclusion and that, even if the analysis is assumed to (...) be correct, it still does not follow that voluntary rehabilitation schemes targeting behaviour beyond the act for which a criminal is convicted are inappropriate. (shrink)

I will argue that the fairly common assumption that brain imaging may compromise people’s privacy in an undesirable way only if moral crimes are committed is false. Sometimes persons’ privacy is compromised because of failures of privacy. A normal emotional reaction to failures of privacy is embarrassment and shame, not moral resentment like in the cases of violations of right to privacy. I will claim that if (1) neuroimaging will provide all kinds of information about persons’ inner life and not (...) only information that is intentionally searched for, and (2) there will be more and more application fields of fMRI and more and more people whose brains will be scanned (without any coercion), then, in the future, shame may be an unfortunately common feeling in our culture. This is because failures of privacy may dramatically increase. A person may feel shame strongly and long, especially if his failure is witnessed by people who he considers relatively important, but less than perfectly trustworthy. (shrink)

Medical professionals, including mental health professionals, largely agree that moral judgment should be kept out of clinical settings. The rationale is simple: moral judgment has the capacity to impair clinical judgment in ways that could harm the patient. However, when the patient is suffering from a "Cluster B" personality disorder, keeping moral judgment out of the clinic might appear impossible, not only in practice but also in theory. For the diagnostic criteria associated with these particular disorders (Antisocial, Borderline, Histrionic, Narcissistic) (...) are expressed in overtly moral language. I consider three proposals for dealing with this problem. The first is to eliminate the Cluster B disorders from the DSM on the grounds that they are moral, rather than mental, disorders. The second is to replace the morally laden language of the diagnostic criteria with morally neutral language. The third is to disambiguate the notion of moral judgment so as to respect the distinction between having morally disvalued traits and having moral responsibility for those traits. Sensitivity to this distinction enables the clinician, at least in theory, to employ morally laden diagnostic criteria without adopting the sort of morally judgmental (and potentially harmful) attitude that results from the tacit presumption of moral responsibility. I argue against the first two proposals and in favor of the third. In doing so, I appeal to Grice's distinction between conventional and conversational implicature. I close with a few brief remarks on the irony of retaining overtly moral language in an ostensibly medical manual for the diagnosis of mental disorders. (shrink)

The concept of “ethical research” holds considerable sway over the ways in which contemporary biomedical, natural, and social science investigations are funded, regulated, and practiced within a variety of countries. Some commentators have viewed this “new” means of governance positively; others, however, have been resoundingly critical, regarding it as restrictive and ethics bodies and regulations unfit for the task they have been set. Regardless, it is clear that science today is an “ethical” business. The ways in which formal and informal (...) ethical discourses and practices—what might be called “regimes of normativity”—structure scientific work and the meanings it is ascribed with have, however, been underexplored. This article attends to how science and ethics articulate; how they are, in many ways, co-produced. Exploring these processes of co-production casts into sharp relief the essential emotionality of science; the relationships investigators have with their colleagues, work, and research participants pulse with emotion, potentially shaping in important ways the very kinds of knowledge that laboratories produce. (shrink)

Research on hybrid bionic systems (HBSs) is still in its infancy but promising results have already been achieved in laboratories. Experiments on humans and animals show that artificial devices can be controlled by neural signals. These results suggest that HBS technologies can be employed to restore sensorimotor functionalities in disabled and elderly people. At the same time, HBS research raises ethical concerns related to possible exogenous and endogenous limitations to human autonomy and freedom. The analysis of these concerns requires reflecting (...) on the availability of scientific models accounting for key aspects of sensorimotor coordination and plastic adaptation mechanisms in the brain. (shrink)

For over a century, scientists have sought to see through the protective shield of the human skull and into the living brain. Today, an array of technologies allows researchers and clinicians to create astonishingly detailed images of our brain's structure as well as colorful depictions of the electrical and physiological changes that occur within it when we see, hear, think and feel. These technologies—and the images they generate—are an increasingly important tool in medicine and science.Given the role that neuroimaging technologies (...) now play in biomedical research, both neuroscientists and nonexperts should aim to be as clear as possible about how neuroimages are made and what they can—and cannot—tell us. Add to this that neuroimages have begun to be used in courtrooms at both the determination of guilt and sentencing stages, that they are being employed by marketers to refine advertisements and develop new products, that they are being sold to consumers for the diagnosis of mental disorders and for the detection of lies, and that they are being employed in arguments about the nature (or absence) of powerful concepts like free will and personhood, and the need for citizens to have a basic understanding of how this technology works and what it can and cannot tell us becomes even more pressing. (shrink)

Progress in Neuroscience advances rapidly and promises to change some of the basic concepts we have about ourselves. The field of Neuroethics is concerned with the resulting ethical implications. In this paper, we propose a framework to systematize the questions and positions in this context. We start with the discussion of three concrete cases around the topics of treatment/enhancement, personhood and privacy. For each case, we get a set of axes along which standpoints may vary. Finally, we generalize the particular (...) axes of each case and arrive at a three-dimensional coordinate system spanned by the axes of “Liberty of Denial”, “Liberty of Use” and “Scepticism”. With this, we hope to provide a common language simplifying interdisciplinary dialogue and communication with the public. (shrink)

The paper discusses criticisms against pharmacological cognitive enhancement from a liberal perspective. The criticisms point to the consequences of cognitive enhancement in third parties and in the agents, as well as in independent values. According to the article, these criticisms are not convincing. On the contrary, it argues that under certain assumptions there are good reasons in favor of free access to cognitive enhancement.

In recent years, neuroscience has been making dramatic progress. The discipline holds great promise but also raises a number of important ethical concerns. Among these is the concern that, some day in the distant future, we will have brain scanners capable of reading our minds, thus making our inner thoughts transparent to others. There are at least two reasons why we might regret our resulting loss of privacy. One is, so the argument goes, that this would undermine our ability to (...) form intimate relations. Another is that the omnipresent gaze of others would render an authentic inner life impossible. I argue that both of these concerns are exaggerated. First, intimacy might flourish through the differential acknowledgement of knowledge as common knowledge; for example, even if I know that both a friend and my taxi driver know that I have kinky sexual fantasies, I might only acknowledge this as common knowledge and, thus, an admissible piece of conversation with my friend, and this differential acknowledgement might be enforced by norms of social interaction. Second, the gaze of others would become much less oppressive if everyone’s inner lives were transparent to everyone else. I also argue that our minds are already partly transparent to others through the use of non-neuroscience-assisted mindreading techniques and, thus, that the latter offer no distinct threat to mind privacy. I offer an additional argument for this conclusion; to wit, that our minds extend beyond our brains. (shrink)

The new biotechnology raises expectations for modifying human behaviour through its use. This article focuses on the ethical analysis of the not so remote possibility of rehabilitating criminals by means of neurotechnological techniques. The analysis is carried out from a synthetic position of, on the one hand, the consequentialist conception of what is right and, on the other hand, the emphasis on individual liberties. As a result, firstly, the ethical appropriateness of adopting a general predisposition for allowing the neurorehabilitation of (...) prisoners only if it is safe and if they give their consent will be defended. But, at the same time, reasons will be given for requiring, in certain circumstances, the exceptional use of neurotechnology to rehabilitate severely psychopathic prisoners, even against their will, from the same ethical perspective. (shrink)

Detection of deception and confirmation of truth telling with conventional polygraphy raised a host of technical and ethical issues. Recently, newer methods of recording electromagnetic signals from the brain show promise in permitting the detection of deception or truth telling. Some are even being promoted as more accurate than conventional polygraphy. While the new technologies raise issues of personal privacy, acceptable forensic application, and other social issues, the focus of this paper is the technical limitations of the developing technology. Those (...) limitations include the measurement validity of the new technologies, which remains largely unknown. Another set of questions pertains to the psychological paradigms used to model or constrain the target behavior. Finally, there is little standardization in the field, and the vulnerability of the techniques to countermeasures is unknown. Premature application of these technologies outside of research settings should be resisted, and the social conversation about the appropriate parameters of its civil, forensic, and security use should begin. (shrink)

Functional neuroimaging (NI) technologies like Positron Emission Tomography and functional Magnetic Resonance Imaging (fMRI) have revolutionized neuroscience, and provide crucial tools to link cognitive psychology and traditional neuroscientific models. A growing discipline of 'neurophilosophy' brings fMRI evidence to bear on traditional philosophical issues such as weakness of will, moral psychology, rational choice, social interaction, free will, and consciousness. NI has also attracted critical attention from psychologists and from philosophers of science. I review debates over the evidential status of fMRI, including (...) the differences between brain scans and ordinary images, the legitimacy of forward inference and reverse inference, and deductive versus probabilistic accounts of NI evidence. I conclude with a discussion of fMRI as exploratory rather than confirmatory evidence, linking this debate to the growing literature on cognitive ontology. (shrink)

Have you ever noticed that in watch advertisements the time is usually set at 10:10? The reasons and psychological effects of this default time setting are elusive. In Experiment 1, we hypothesized that watches showing a time setting resembling a smiling face (10:10) would enhance emotional valence and intention to buy compared to a neutral time setting (11:30), whereas a time setting resembling a sad face (8:20) would have the opposite effect. Moreover, we investigated a possible interaction effect with the (...) gender of the participants. In Experiment 2, we directly tested the hypotheses that watches set at 10:10 resemble a smiling face, whereas watches set at 8:20 resemble a sad face. The data of the first experiment reveal that watches set at 10:10 showed a significant positive effect on the emotion of the observer and the intention to buy. However, watches set at 8:20 did not show any effect on the emotion or the intention to buy. Moreover, watches set at 10:10 induced in women significantly stronger ratings of pleasure than in men. The data of the second experiment show that participants consistently perceive high resemblance between watches set at 10:10 and a smiling face as well as high resemblance between watches set at 8:20 and a sad face. This study provides for the first time empirical evidence for the notion that using watches with a time setting resembling a smiling face (like 10:10) can positively affect the emotional response of the observers and their evaluation of a seen watch, even though they are not aware of the fact that the shown time setting is inducing this effect. Practical implications of the observed findings and alternative explanations are discussed. (shrink)

This paper argues that many ethical issues in neuroeducational research cannot be appropriately addressed using the principles and guidance available in one of these areas alone, or by applying these in simple combination. Instead, interdisciplinary and public dialogue will be required to develop appropriate normative principles. In developing this argument, it examines neuroscientific and educational perspectives within three broad categories of ethical issue arising at the interface of cognitive neuroscience and education: issues regarding the carrying out of interdisciplinary research, the (...) scrutiny and communication of findings and concepts, and the application of research and associated issues of policy likely to arise in the future. To help highlight the need for interdisciplinary and public discussion, we also report the opinions of a group of educators (comprising trainee teachers, teachers and head teachers) on the neuroeducational ethics of cognitive enhancing drugs, infant screening, genetic profiling and animal research. (shrink)

The important question of the legality of the state obliging trial incompetent defendants to receive competency-restoring treatment against their wishes, is one that has received much attention by legal scholars. Surprisingly, however, little attention has been paid to the, in many ways more fundamental, moral question of whether the state ought to administer such treatments. The aim of this paper is to start filling this gap in the literature. I begin by offering some reasons for thinking it morally acceptable to, (...) at least sometimes, oblige trial-incompetent defendants to receive competency-restoring treatments. The paper then discusses whether three prominent arguments (and their variations) offered by legal scholars against using non-consensual treatment to restore trial competence provide grounds for thinking there to be a general moral prohibition against these treatments. I argue that they do not. (shrink)

Recent advances in neuroscience have led to numerous ethical questions. Neuroethics is the study of ethical, legal and social advancements in neuroscience which, despite being a recently developed discipline, has a long historical tradition. The concern with ethical issues in neuroscience is extremely old and dates back to the philosophical and scientific traditions that originally sought to understand the relationship between the brain and behavior. More recently, the field of neuroethics has emerged in the context of public and academic debate (...) over the consequences of the advances arising from neuroscience. In the current context, technological innovations, which have arisen from the expansion of neuroscience research, have raised new ethical dilemmas. This article aims to analyze the historical course of ethics within the field of neuroscience, specifically the appearance and the recent institutionalization of neuroethics. (shrink)

PurposeSince the 1980s we have witnessed a soaring “extra-therapeutic” use of psycho-pharmacology. But there is also an increasing interest in invasive methods of neuroenhancement that can be subsumed under the term “brain engineering”. The present article aims to identify key issues raised by those forms of neuro-technical enhancement (e.g., deep brain stimulation, brain-computer interfaces, memory chips, neurobionic interventions). First it distinguishes different forms of neuroenhancement, then describes features of those methods and finally discusses their ethical implications.MethodsThe article is based on (...) an in-depth literature study and an ethical assessment of the current and emerging forms of neuroenhancement.ResultsFrom a medical and normative perspective, psycho-pharmacological enhancement and nonpharmacological enhancement by brain engineering demonstrate considerable differences. Many arguments in favour of nonpharmacological enhancement fall short, for they fail to sufficiently consider the medical, anthropological and socio-cultural context. In many respects unsecured use is confronted with considerable risks.ConclusionsResearch on invasive forms of neuroenhancement partly takes place in the fields of (nano-)technology and military, to which health care experts and medical ethicists do not have easy access. This raises the danger of misjudging trends and developmental tendencies. Thus medicine and medical ethics must a priori thematize the goals and risks linked to these questions as well as participate discursively right from the beginning. (shrink)

Many drugs have therapeutic off-label uses for which they were not originally designed. Some drugs designed to treat neuropsychiatric and other disorders may enhance certain normal cognitive and affective functions. Because the long-term effects of cognitive and affective enhancement are not known and may be harmful, a precautionary principle limiting its use seems warranted. As an expression of autonomy, though, competent individuals should be permitted to take cognition- and mood-enhancing agents. But they need to be aware of the risks in (...) chronic use of these agents and to take responsibility for their effects. A reasonable middle ground between these positions is to warn those who choose to enhance that doing so entails risks. (shrink)

Neuroimaging, psychosurgery, deep-brain stimulation, and psychopharmacology hold considerable promise for more accurate prediction and diagnosis and more effective treatment of neurological and psychiatric disorders. Some forms of psychopharmacology may even be able to enhance normal cognitive and affective capacities. But the brain remains the most complex and least understood of all the organs in the human body. Mapping the neural correlates of the mind through brain scans, and altering these correlates through surgery, stimulation, or pharmacological interventions can affect us in (...) both positive and negative ways. We need to carefully weigh the potential benefit against the potential harm of such techniques. This paper examines some of these techniques and explores the emerging ethical issues in clinical neuroscience. (shrink)

The extra-therapeutic use of psychotropic drugs to improve cognition and to enhance mood has been the subject of controversial discussion in bioethics, in medicine but also in public for many years. Concerns over a liberal dealing with pharmacological enhancers are raised not only from a biomedical–pharmacological perspective, but particularly from an ethical one. Within these ethical concerns, there is one objection about the normative differentiation between “natural” and “artificial” enhancers, which is theoretically indeed widely discredited in bioethics, which has, however, (...) entrenched itself in such a persistent way in everyday moral consciousness that it keeps a crucial influence on the assessment of pharmacological enhancers made by the public and medical professionals. This paper tries to first show why a normative differentiation between “natural” and “artificial” enhancers is highly problematic. In a second step, the resulting implications for our current dealing with pharmacological enhancers shall be examined. In a specific comparison of synthetic pharmaceuticals (modafinil, SSRIs) with phytopharmaceuticals (ginkgo biloba, St. John’s wort) and other already established enhancers (alcohol, caffeine), argumentative inconsistencies are pointed out which, at least partly, result from a rationally untenable preference for the “natural” over the “artificial”. Therefore, it is conclusively argued the case for an unprejudiced assessment of pharmacological enhancers beyond a “natural”–“artificial” dichotomy, which equally takes into account biomedical and ethical aspects. The goal is to reach a coherent dealing with pharmacological enhancement in the long run. (shrink)

This paper argues that the cognitive neuroscientific use of ordinary mental terms to report research results and draw implications can contribute to public confusion and misunderstanding regarding neuroscience results. This concern is raised at a time when cognitive neuroscientists are increasingly required by funding agencies to link their research to specific results of public benefit, and when neuroethicists have called for greater attention to public communication of neuroscience. The paper identifies an ethical dimension to the problem and presses for greater (...) sensitivity and responsibility among neuroscientists regarding their use of such terms. (shrink)

The enhancement debate in neuroscience and biomedical ethics tends to focus on the augmentation of certain capacities or functions: memory, learning, attention, and the like. Typically, the point of contention is whether these augmentative enhancements should be considered permissible for individuals with no particular “medical” disadvantage along any of the dimensions of interest. Less frequently addressed in the literature, however, is the fact that sometimes the _diminishment_ of a capacity or function, under the right set of circumstances, could plausibly contribute (...) to an individual's overall well-being: more is not always better, and sometimes less is more. Such cases may be especially likely, we suggest, when trade-offs in our modern environment have shifted since the environment of evolutionary adaptation. In this article, we introduce the notion of “diminishment as enhancement” and go on to defend a _welfarist_ conception of enhancement. We show how this conception resolves a number of definitional ambiguities in the enhancement literature, and we suggest that it can provide a useful framework for thinking about the use of emerging neurotechnologies to promote human flourishing. (shrink)

The end of the 20th century became a milestone for the progress of Neurosciences and their contribution to a better understanding of the physiological mechanisms involved in cognition, mood and human behavior. Because of this, it was possible not only to intervene some of the aforementioned aspects with therapeutic purposes, but more recently they became objects of study in researches with a more pragmatic nature, such as clinical researches involving persons with no mental or physical disorders, but who require to (...) prove remarkable abilities for executive functions, e.g., soldiers, pilots, students, among others. On the other hand, there is an ethical and scientific debate over the interest to evaluate certain psychotropic medications due to its possible sideeffects as cognitive enhancers in healthy subjects that, because of their social status, might be benefited in their social, academic or work life by developing a better mental performance. Therefore, the article aims to present from the perspective of Bioethics and Psychopharmacology some aspects of the research in Neurosciences that might throw light upon the scientific debate oriented towards the social significance of such clinical studies and their possible consequences for the future. (shrink)

In recent years, direct brain interventions have shown increased success in manipulating neurobiological processes often associated with moral reasoning and decision-making. As current DBIs are refined, and new technologies are developed, the state will have an interest in administering DBIs to criminal offenders for rehabilitative purposes. However, it is generally assumed that the state is not justified in directly intruding in an offender’s brain without valid consent. Thomas Douglas challenges this view. The state already forces criminal offenders to go to (...) jail without their consent. This represents a serious interference with an offender’s rights. If criminal offenders are already morally liable to incarceration, why is the state not also entitled to administer DBIs without consent for the purposes of rehabilitation? Douglas argument focuses on the right to ‘bodily integrity’. He argues that there is no compelling reason to believe that bodily rights that protect an offender from non-consensual DBIs are stronger than rights that protect an offender from incarceration. This paper will extend Douglas’ analysis. It will consider the more fundamental right to ‘mental integrity’. The right to mental integrity defends an inner sphere of liberty. It protects critical capacities necessary for the exercise of autonomous human agency—without which a vast majority of moral rights could not exist. Thus, the right to mental integrity is ultimately more important for a moral assessment of DBIs. The right strongly suggests that both presently, and in the future, there may be many cases in which the state is not entitled to administer DBIs to criminal offenders without valid consent. (shrink)

Advances in cognitive neuroscience make cosmetic neurology in some form inevitable and will give rise to extremely difficult ethical issuesConsider the following hypothetical case study. A well heeled executive walks into my cognitive neurology clinic because he is concerned that he is becoming forgetful. It turns out that he is going through a difficult divorce and my clinical impression is that his memory problems stem from the stress he is experiencing. I place him on a selective seratonin reuptake inhibitor, sertraline, (...) and in a few weeks he feels better. Around this time his 13 year old daughter has difficulty at school and is diagnosed by the school psychologist as having attention deficit disorder. I place her on adderall, a stimulant combination drug, which seems to help with her behaviour in school. My patient then comes to me because he is experiencing the “tip of the tongue” phenomena more frequently. He is concerned that his word finding difficulty interferes with his ability to function in high level meetings. I suggest we try a cholinesterase inhibitor to see if this helps. I am careful to explain that the Food and Drug Administration does not approve such a use for this medication. He wants to try it and is pleased with the results.A few months later, this patient visits me with his 16 year old son, a talented middle distance runner. His father thinks if he were just a bit better, among the elite high school runners in the state, he would be far more competitive as an applicant for selective colleges. We discuss various options. Because of a recent report that sildenafil, which is used conventionally for male impotence, may improve oxygen carrying capacity, I prescribe this medication. The son does not object.Encouraged by these pharmacologic successes, my patient …. (shrink)

Reports in the popular press suggest that smart drugs or “nootropics” such as methylphenidate, modafinil and piracetam are increasingly being used by the healthy to augment cognitive ability. Although current nootropics offer only modest improvements in cognitive performance, it appears likely that more effective compounds will be developed in the future and that their off-label use will increase. One sphere in which the use of these drugs may be commonplace is by healthy students within academia. This article reviews the ethical (...) and pragmatic implications of nootropic use in academia by drawing parallels with issues relevant to the drugs in sport debate. It is often argued that performance-enhancing drugs should be prohibited because they create an uneven playing field. However, this appears dubious given that “unfair” advantages are already ubiquitous and generally tolerated by society. There are concerns that widespread use will indirectly coerce non-users also to employ nootropics in order to remain competitive. However, to restrict the autonomy of all people for fear that it may influence the actions of some is untenable. The use of potentially harmful drugs for the purposes of enhancement rather than treatment is often seen as unjustified, and libertarian approaches generally champion the rights of the individual in deciding if these risks are acceptable. Finally, whether the prohibition of nootropics can be effectively enforced is doubtful. As nootropics use becomes widespread among students in the future, discussion of this issue will become more pressing in the years to come. (shrink)

Criminal offenders may be offered to participate in voluntary rehabilitation programs aiming at correcting undesirable behaviour, as a condition of early release. Behavioural treatment may include direct intervention into the central nervous system (CNS). This article discusses under which circumstances voluntary rehabilitation by CNS intervention is justified. It is argued that although the context of voluntary rehabilitation is a coercive circumstance, consent may still be effective, in the sense that it can meet formal criteria for informed consent. Further, for a (...) consent to be normatively valid (“take the wronging out of the act”) under a coercive circumstance, the subject to be treated must (1) have the sovereign authority to consent, and (2) the offer-giver must be in the right normative position to make the offer. While I argue that subjects do have the sovereign authority to consent to treatment, I also argue that inappropriate offers yield invalid consents. Considerations on inappropriate offers should therefore inform which kinds of CNS intervention-based rehabilitation schemes the state may propose as part of the criminal justice system. Yet as I conclude in this paper, while there are some intrinsic constraints on voluntary rehabilitation programs, the main constraints on voluntary rehabilitation are likely to be contingent overriders. However, CNS intervention is not ruled out as such in the context of voluntary rehabilitation. (shrink)

There is currently little empirical information about attitudes towards cognitive enhancement - the use of pharmaceutical drugs to enhance normal brain functioning. It is claimed this behaviour most commonly occurs in students to aid studying. We undertook a qualitative assessment of attitudes towards cognitive enhancement by conducting 19 semi-structured interviews with Australian university students. Most students considered cognitive enhancement to be unacceptable, in part because they believed it to be unethical but there was a lack of consensus on whether it (...) was similar or different to steroid use in sport. There was support for awareness campaigns and monitoring of cognitive enhancement use of pharmaceutical drugs. An understanding of student attitudes towards cognitive enhancement is important in formulating future policy. (shrink)

In recent years, neuroscience has been a particularly prolific discipline stimulating many innovative treatment approaches in medicine. However, when it comes to the brain, new techniques of intervention do not always meet with a positive public response, in spite of promising therapeutic benefits. The reason for this caution clearly is the brain’s special importance as “organ of the mind”. As such it is widely held to be the origin of mankind’s unique position among living beings. Likewise, on the level of (...) the individual human being, the brain is considered the material substrate of those traits that in combination render each person unique. In view of this preeminent significance of the brain, it is understandable that, in general, interventions into the brain are considered a delicate issue and that new techniques of intervention are scrutinised with particular care. However, in doing so it is important not to go to the opposite extreme and shy away from promising new therapeutic approaches for debilitating disorders of the brain. With respect to the new techniques of brain intervention a broad interdisciplinary perspective is required to discern irrational fear from justified concern. Hence, the Europäische Akademie established a project group consisting, on the one hand, of experts from different fields of medicine who have got first-hand experience of applying the techniques at issue and, on the other hand, of philosophers and a legal expert. The task of this team was to review the state of the art with respect to each single technique of intervening in the brain, to indicate future developments, and to address the ethical and legal issues common to all of them. The project’s outcome is the book at hand. (shrink)

This collection of papers were originally presented during conferences on ethics in science and technology that UNESCO’s Regional Unit for Social and Human Sciences (RUSHSAP) has been convening since 2005. Since intercultural communication and information-sharing are essential components of these deliberations, the books also provide theme-related discourse from the conferences.

In this chapter, I propose the mechanism of cognitive enhancement based on studies of cognitive-enhancing drugs and behavioral training. I argue that there are mechanistic differences between cognitive-enhancing drugs and behavioral training due to their different enhancing effects. I also suggest possible mechanisms for cognitive-enhancing drugs and behavioral training and for the synergistic effects of their simultaneous application.