As Jan Christoph Bublitz (2024) rightly notes, the first international declaration on neurotechnologies and human rights would set the tone for further international and domestic regulations. For t...

International institutions such as UNESCO are deliberating on a new standard setting instrument for neurotechnologies. This will likely lead to the adoption of a soft law document which will be the first global document specifically tailored to neurotechnologies, setting the tone for further international or domestic regulations. While some stakeholders have been consulted, these developments have so far evaded the broader attention of the neuroscience, neurotech, and neuroethics communities. To initiate a broader debate, this target article puts to discussion twenty-five (...) considerations and desiderata for recognition by a future instrument. They are formulated at different levels of abstraction, from the big picture to technical details, seek to widen the perspective of preparatory reports and transcend the narrow debate about “neurorights” which overshadows many richer and more relevant aspects. These desiderata are not an exhaustive enumeration but a starting point for discussions about what deserves and what requires protection by an international instrument. (shrink)

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

Given the past two decades of over 40 failed trials of amyloid-lowering therapies in Alzheimer’s Disease (AD), many of which succeeded in lowering amyloid as designed, we present an ethical argument for emptying the drug pipeline of tests of amyloid-lowering agents so as to end the historical dominance of the amyloid-reducing therapeutic approach in AD.

In their interesting paper, Susser and Cabrera (2024) apply the contextual integrity framework to brain data and mental privacy. This framework, developed by Nissenbaum (2009) and rooted in digital...

In their paper “Brain Data in Context: Are New Rights the Way to Mental and Brain Privacy?” Susser and Cabrera (2024) argue against the notion that specific rights may be necessary to protect “brai...

The intersection of AI and neurotechnology has resulted in an increasing number of medical and non-medical applications and has sparked debate over the need for new human rights, or “neurorights,”...

Do we need a right to mental privacy? In an era of increasing sophistication in recording, interpreting, and directly intervening on our neural activity – not to mention efforts at combining neural...

The last several years have seen vibrant debates among policymakers and scholars on whether to craft new human rights (or novel interpretations of existing ones) around neurotechnologies. These con...

Discussions about brain data and privacy, particularly those advocating for human rights frameworks, at times, have embodied problematic undercurrents of, if not overt appeals to, neuro-exceptional...

Susser and Cabrera (2024) assess the role of bespoke neuro-privacy regulations including the creation of a novel right to mental privacy. They argue that focusing on what distinguishes mental priva...

The psychedelic psilocybin has shown promise both as treatment for psychiatric conditions and as a means of improving well-being in healthy individuals. In some jurisdictions (e.g., Oregon, USA), psilocybin use for both purposes is or will soon be allowed and yet, public attitudes toward this shift are understudied. We asked a nationally representative sample of 795 US Americans to evaluate the moral status of psilocybin use in an appropriately licensed setting for either treatment of a psychiatric condition or well-being enhancement. (...) Showing strong bipartisan support, participants rated the individual’s decision as morally positive in both contexts. These results can inform effective policy-making decisions around supervised psilocybin use, given robust public attitudes as elicited in the context of an innovative regulatory model. We did not explore attitudes to psilocybin use in unsupervised or non-licensed community or social settings. (shrink)

In “Brain Data in Context: Are New Rights the Way to Mental and Brain Privacy?” Daniel Susser and Laura Cabrera (2024) make a compelling case as to why the greater availability of neural data itsel...

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

The recent emergence of reprogramming technologies to convert brain cell types or epigenetically alter neurons and neural progenitors in vivo and in situ hold significant promises in brain repair and neuronal aging reversal. However, given the significant epigenetic and transcriptomic changes to components of the existing neuronal cells and network, we question if these reprogramming technology might inadvertently alter or erase memory engrams, conceivably resulting in changes in narrative identity or personality. We suggest that the nature of these alterations might (...) be less predictable compared to memory and personality changes known to be associated with diseases, drugs or brain stimulation therapies. While research in applying reprogramming technologies to neurological ailments and aging should continue, more targeted analyses should be put in place in animal experiments to gauge the severity and degree of memory alterations, and appropriate risk and benefit analyses should be conducted before these technologies move into human trials. (shrink)

Neurotechnologies are revolutionizing our ability to monitor and modify the brain. As these technologies gather more data, many seek to understand whether brain data raises novel privacy concerns a...

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

As neurotechnologies continue to develop and diffuse, this fast-paced field must be guided by robust governance frameworks in order to promote responsible innovation. The article by Bublitz (2024)...

Dorfman et al. (2024) survey psychiatrists’ perceptions of patients with “extremely” treatment-refractory symptoms, finding that many psychiatrists would continue recommending treatment despite the...

Dorfman et al.’s (2024) study on psychiatrists’ perceptions of treatment-refractory mental illness found that while most psychiatrists recognize there are cases where further treatment may no longe...

Crutchfield and Redinger (2024) argue that, ceteris paribus, it is morally worse to deploy a restraint that undermines a basic liberty than one that does not.1 This is a plausible view, and is like...

Background Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals’ judgments of stigma, empathy, and compassion.Methods We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, empathy, (...) and compassion.Results Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists.Conclusions The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others. (shrink)

Dorfman et al. (2024) make a significant empirical contribution to a growing body of literature pertaining to issues of futility in psychiatry. The authors acknowledge that their survey methodologi...

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

The brain requires sustained interaction with a rich physical and social environment to stay healthy. Individuals without access to such enabling environments and who instead live and grow in disabling environments tend to have greater risk of developing dementia. But research and policymaking as regards dementia risk reduction have so far focused almost exclusively on the role of how individuals’ health behaviors change their risk profile. This exclusive focus on “lifestyle” is both ethically problematic and therapeutically inadequate. I highlight a (...) growing literature on three different kinds of deprivation, an independent and overlooked risk factor for dementia that invites upstream action against inequalities. Future prevention guidelines should include explicit mention of deprivation as a risk factor and be developed around the need to make society fairer. Meanwhile, interventions and discourse based on lifestyle modification should respect the principle of “no ought without support.”. (shrink)

Crutchfield and Redinger argue that consciousness-altering chemical restraints are less “liberty-intrusive” (or as we will sometimes put it, just less “intrusive”) than physical restraints. Physica...

Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging (...) treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments. (shrink)

In The Conditions for Ethical Chemical Restraint, Crutchfield and Redinger (2024) propose ethical standards for the use of chemical restraints, which they consider normatively distinct from physica...

As the new Editor-in-Chief (EiC) of the AJOB Neuroscience, I am aware that I have some very large shoes to fill. Paul Root Wolpe, who established the quality of the journal and served in that posit...

Buchman et al.'s (2024) paper illuminates a pressing issue concerning the utilization of machine learning (ML) in psychiatric care, shedding light on its potential to exacerbate stigma and social d...

Crutchfield and Redinger (2024) propose that the use of a chemical restraint that affects only a particular conscious state is ethically permissible if, and only if, (1) it is the least restrictive...

The recent push to extend physician-aid-in-dying (PAD) to psychiatric conditions has significantly altered the ethical landscape surrounding psychiatric judgments concerning treatment-refractory il...

We thank the authors of commentaries for their thoughtful discussion of our target article. Here we briefly summarize the points made in the target article (Nair-Collins and Joffe 2023). Then we em...

In their article, Crutchfield and Redinger (2024) outline the conditions that they have identified as situations in which it is ethically permissible to use chemical restraints, defined as medicati...

In their stimulating article, “What do psychiatrists think about caring for patients who have extremely treatment-refractory illness?,” Dorfman et al. (2024) survey 212 U.S. psychiatrists to gauge...

Words we use to characterize mental states matter; they affect, for better or worse, the individual whose mental states are in question. For example, referring to a child whose behavior seems a bit...

Crutchfield and Redinger (2024) maintain that “being conscious is a basic liberty,” and infer from this that without informed consent, deep sedation, by intruding upon one’s consciousness, is an in...