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 neuroscience might make it possible to develop techniques for directly altering offenders’ brains, in order to make offenders more responsible and law-abiding. The idea of using such techniques within the criminal justice system can seem intuitively troubling, even if they were more effective in preventing crime than traditional methods of rehabilitation. One standard argument against this use of brain interventions is that it would undermine the individual’s free will. This paper maintains that ‘free will’ (at least, as (...) that notion is understood by those who adopt the influential compatibilist approach) is an inadequate basis for explaining what is problematic about some direct brain interventions. This paper then defends an alternative way of objecting to certain kinds of direct brain interventions, focusing on the relationship between the offender and the state rather than the notion of free will. It opposes the use of interventions which aim to enhance ‘virtue responsibility’ (by instilling particular values about what is right and wrong), arguing that this would objectify offenders. In contrast, it argues that it may be acceptable to use direct brain interventions to enhance ‘capacity responsibility’ (i.e. to strengthen the abilities necessary for the exercise of responsible agency, such as self-control). Finally it considers how to distinguish these different kinds of responsibility enhancement. (shrink)

This issue of Criminal Law and Philosophy contains three papers on a topic of increasing importance within the field of "neurolaw"-namely, the implications for criminal law of direct brain intervention based mind altering techniques. To locate these papers' topic within a broader context, I begin with an overview of some prominent topics in the field of neurolaw, where possible providing some references to relevant literature. The specific questions asked by the three authors, as well as their answers (...) and central claims, are then sketched out, and I end with a brief comment to explain why this particular topic can be expected to gain more prominence in coming years. (shrink)

This paper critically discusses the argument from objectification – as recently presented by Elizabeth Shaw – against mandatory direct brain interventions targeting criminal offenders’ values as part of rehabilitative or reformative schemes. Shaw contends that such DBIs would objectify offenders because a DBI “excludes offenders by portraying them as a group to whom we need not listen” and “implies that offenders are radically defective with regard to one of the most fundamental aspects of their agency”. To ensure that (...) offenders are not objectified, Shaw first maintains that we should restrict rehabilitative/reformative schemes to attempts at rational dialogue because such an approach respects the offender’s personhood. Second, Shaw claims that we should not portray offenders as radically defective because such treatment would only negatively impact offenders’ already tenuous relationship with society. Third, Shaw contends that we should not confer the state the power to change an offender’s values because the state lacks insight into what constitutes the right values. I contend that none of these arguments should prevent the use of value-targeting DBIs. First, I show that the dialogue requirement for rehabilitative schemes is insufficient ground from which to oppose the use of these DBIs. Second, I show that it is doubtful that the use of DBIs as proposed would damage the relationship between offenders and society. Finally, although the state may often lack insight into what constitutes the correct values, this lack of insight should not by itself prevent value-targeting DBIs from being employed on certain groups of offenders. (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)

ArgumentThis essay considers the metaphors of projection in Hugo Münsterberg's theory of cinema spectatorship. Münsterberg (1863–1916), a German born and educated professor of psychology at Harvard University, turned his attention to cinema only a few years before his untimely death at the age of fifty-three. But he brought to the new medium certain lasting preoccupations. This account begins with the contention that Münsterberg's intervention in the cinema discussion pursued his well-established strategy of pitting a laboratory model against a clinical (...) one, in this case the “master-trope” of early cinema a spectatorship drawn from hysteria, hypnosis, and related phenomena like double-consciousness. Münsterberg's laboratory-oriented account also flowed from his account of cinema technology as an outgrowth of the apparatus of his own discipline of experimental psycho-physiology, which entailed a model of cinema spectatorship continuous with the epistemological setting of laboratory relations. I argue that inThe Photoplayand related writings projection functioned in three registers: material, psychological, and philosophical. Münsterberg's primary concern was with psychological projection, where he drew upon his own work in experimental aesthetics to articulate an account of how the basic automatisms of cinema produce a state of oscillation between immersion and distraction. I show how Münsterberg's experimental aesthetics drew upon German doctrines of aesthetic empathy, orEinfühlung, which Münsterberg sought to modify in accordance with the dynamic and temporal characteristics of psycho-physiological experiment. Finally, I argue that Münsterberg's cinema theory was enfolded in his action or double-standpoint theory, in which the transcendental self posits the material, objective conditions of laboratory experience as a means to know itself. This philosophical projection explained cinema's uncanny ability to suspend ordinary perceptions of space, time, and causality. It also made cinema uniquely suited for the philosophical emancipation of a popular mass audience. (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)

Although contemporary sociologists of science have sometimes claimed Max Weber as a methodological precursor, they have not examined Weber's own writings about science. Between 1908 and 1912 Weber published a series of critical studies of the extension of scientific authority into public life. The most notable of these concerned attempts to implement the experimental psychology or psycho-physics laboratory in factories and other real-world settings. Weber's critique centered on the problem of social measurement. He emphasized the discontinuities between the space of (...) the laboratory and that of the factory, showing how several qualitative and historically conditioned differences between the two settings rendered the transfer of instruments and methods between them highly problematic. Weber's critical arguments prepared the ground for his greatest foray into empirical sociology, a survey he directed for the Verein für Sozialpolitik investigating the conditions and attitudes affecting the lives and performance of industrial workers. Using a different measuring instrument — the questionnaire — Weber tried to implement a concept of social measurement which implied a different ontology, drawn not from natural sciences but from the historical sciences. (shrink)

ObjectiveThis systematic review aims to analyze existing literature of the effects of transcranial direct current stimulation (tDCS) on motor skills learning of healthy adults and discuss the underlying neurophysiological mechanism that influences motor skills learning.MethodsThis systematic review has followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses. The PubMed, EBSCO, and Web of Science databases were systematically searched for relevant studies that were published from database inception to May 2022. Studies were included based on the (...) Participants, Intervention, Comparison, Outcomes, and Setting inclusion strategy. The risk of bias was evaluated by using the Review manager 5.4 tool. The quality of each study was assessed with the Physiotherapy Evidence Database (PEDro) scale.ResultsThe electronic search produced 142 studies. Only 11 studies were included after filtering. These studies performed well in terms of distribution, blinding availability and selective reporting. They reported that tDCS significantly improved motor skills learning. The main outcomes measure were the improvement of the motor sequence tasks and specific motor skills. Nine studies showed that tDCS interventions reduced reaction time to complete motor sequence tasks in healthy adults and two studies showed that tDCS interventions improved golf putting task performance.ConclusionThe included studies showed that tDCS can help healthy adults to improve the motor skills learning by activating different brain regions, such as the primary motor cortex, left dorsolateral prefrontal cortex and right cerebellum. However, the number of included studies was limited, and the sample sizes were small. Therefore, more studies are urgently needed to validate the results of current studies and further explore the underlying neurophysiological mechanisms of tDCS in the future. (shrink)

‘Moral bioenhancement’ refers to the use of pharmaceuticals and other direct brain interventions to enhance ‘moral’ traits such as ‘empathy,’ and alter any ‘morally problematic’ dispositions, such as ‘aggression.’ This is believed to result in improved moral responses. In a recent paper, Tom Douglas considers whether medical interventions of this sort could be “provided as part of the criminal justice system’s response to the commission of crime, and for the purposes of facilitating rehabilitation : 101–122, 2014).” He suggests (...) that they could “at least in some cases, permissibly be provided without valid consent : 101–122, 2014)” as a form of rehabilitative punishment. He argues for this conclusion by ‘parity of reasoning,’ starting from the currently accepted practice of non-consensual incarceration. His argument appears to be dependent on the successful defence of the following two claims: that non-consensual incarceration is a morally justifiable practice, and that there is no meaningful distinction between the forcible imposition of this practice, and the forcible imposition of medical interventions on prisoners. From both claims, he deduces : if non-consensual incarceration is morally justifiable, so is the non-consensual imposition of medical correctives, in some cases. In this paper, I begin by suggesting that the basic argument behind the Parity Claim results in a reductio ad absurdum, whereby any practice that is sufficiently similar to incarceration in the ways Douglas presents, would also be considered permissible. This appears to be an unpalatable conclusion, casting doubt on the soundness of a key premise. Douglas appears to offer no means of deciding which practices are sufficiently similar to incarceration in terms of harm and threat to agency, and of the practices that I will present, which do seem to be, it does not seem that he could rule them out in any principled way. Next I turn to dispute claim relating to the purported justifiability of incarceration on rehabilitative grounds. If successful, this attack causes a break in reasoning from the justifiability of incarceration, to the justifiability of medical interventions. Medical interventions would then require an alternative, independent justification, through outlining the ways in which they are conducive to a particular aim of punishment, without relying on the justifiability of incarceration. This argument has not been provided, and I suggest that attempts to do so may run into difficulty. I untangle and make explicit the various assumptions made in Douglas’ contention that medical interventions “might be thought conducive to rehabilitation in some offenders,” locating my critique in the wider debate on the causes of crime. Finally, I seek to challenge the normative weight of the Parity Claim, arguing that to show that two practices are comparable in some sense is not sufficient to show that both are equally as permissible. Other social purposes must be considered, leading me to suggest that the forcible imposition medical correctives falls beyond the appropriate remit of the criminal justice system. (shrink)

This book begins well. Blank first gives, for the benefit of lay readers and those unfamiliar with the area of neuroscience, a brief but informative description of the structure and workings of the brain itself. He then goes on to offer an overview of the current state of brain intervention ranging from direct brain intervention (electroconvulsive therapy, electronic and magnetic stimulation, psychosurgery and neural implants), psychotropic drugs, the use of virtual reality, nootropics and neurogenetics. (...) Blank offers a concise summary and evaluation of each of these methods, outlining both potential benefits and risks. He makes the important point that most of these methods, however, do not present a cure, but rather are aimed at altering behaviour, raising the important question as the ethics of behavioural control for social convenience – particularly in relation to the vulnerable, such as the management of children with ADHD.Blank then offers a well-researched and balanced overview .. (shrink)

Brain-Computer Interface is a set of technologies that are of increasing interest to researchers. BCI has been proposed as assistive technology for individuals who are non-communicative or paralyzed, such as those with amyotrophic lateral sclerosis or spinal cord injury. The technology has also been suggested for enhancement and entertainment uses, and there are companies currently marketing BCI devices for those purposes as well as health-related purposes. The unprecedented direct connection created by BCI between human brains and computer hardware (...) raises various ethical, social, and legal challenges that merit further examination and discussion. To identify and characterize the key issues associated with BCI use, we performed a scoping review of biomedical ethics literature, analyzing the ethics concerns cited across multiple disciplines, including philosophy and medicine. Based on this investigation, we report that BCI research and its potential translation to therapeutic intervention generate significant ethical, legal, and social concerns, notably with regards to personhood, stigma, autonomy, privacy, research ethics, safety, responsibility, and justice. Our review of the literature determined, furthermore, that while these issues have been enumerated extensively, few concrete recommendations have been expressed. We conclude that future research should focus on remedying a lack of practical solutions to the ethical challenges of BCI, alongside the collection of empirical data on the perspectives of the public, BCI users, and BCI researchers. (shrink)

A considerable body of evidence now documents, beyond reasonable doubt, biological and health risk factors for crime and violence. Nevertheless, intervention and prevention efforts with offenders have avoided biological interventions, in part due to past misuses of biological research and the challenges that biological predispositions to crime raise. This article reviews the empirical literature on two biological intervention approaches, omega-3 supplementation and transcranial direct current stimulation. Emerging research on these relatively benign interventions suggests that increased omega-3 intake (...) through dietary intervention and prefrontal upregulation using non-invasive brain stimulation may show some initial promise in reducing antisocial behavior. The ethical issues related to mandated and offered biological interventions within the criminal justice system are discussed. (shrink)

Gilbert et al. have raised important questions about the empirical grounding of neuroethical analyses of the apparent phenomenon of Deep Brain Stimulation ‘causing’ personality changes. In this paper, we consider how to make neuroethical claims appropriately calibrated to existing evidence, and the role that philosophical neuroethics has to play in this enterprise of ‘evidence-based neuroethics’. In the first half of the paper, we begin by highlighting the challenges we face in investigating changes to PIAAAS following DBS, explaining how different (...) trial designs may be of different degrees of utility, depending on how changes to PIAAAS following DBS are manifested. In particular, we suggest that the trial designs Gilbert et al. call for may not be able to tell us whether or not DBS directly causes changes to personality. However, we suggest that this is not the most significant question about this phenomenon; the most significant question is whether these changes should matter morally, however they are caused. We go on to suggest that neuroethical analyses of novel neuro-interventions should be carried out in accordance with the levels of evidence hierarchy outlined by the Centre for Evidence-Based Medicine, and explain different ways in which neuroethical analyses of changes to PIAAAS can be evidence-based on this framework. In the second half of the paper, we explain how philosophical neuroethics can play an important role in contributing to mechanism-based reasoning about potential effects on PIAAAS following DBS, a form of evidence that is also incorporated into the CEBM levels of evidence hierarchy. (shrink)

To maximize brain plasticity after stroke, several rehabilitation strategies have been explored, including the use of intensive motor training, motor imagery, and action observation. Growing evidence of the positive impact of virtual reality (VR) techniques on recovery following stroke has been shown. However, most VR tools are designed to exploit active movement, and hence patients with low level of motor control cannot fully benefit from them. Consequently, the idea of directly training the central nervous system has been promoted by (...) utilizing motor-imagery (MI) based brain-computer interfaces (BCIs). To date, detailed information on which VR strategies lead to successful functional recovery is still largely missing, and very little is known about how to optimally integrate BCI and VR paradigms for stroke rehabilitation. The purpose of this study was to examine the efficacy of a BCI-VR system using a MI paradigm for post-stroke upper limb rehabilitation on functional assessments, and related changes in MI ability and brain imaging. To achieve this, a 60 years old male chronic stroke patient was recruited. The patient underwent a 3-week intervention in a clinical environment, resulting in 10 BCI-VR training sessions. The patient was assessed before and after intervention, as well as on a one-month follow-up, in terms of clinical scales and brain imaging using functional MRI (fMRI). Consistent with prior research, we found important improvements in upper extremity scores (Fugl-Meyer) and identified increases in brain activation measured by fMRI that suggest neuroplastic changes in brain motor networks. This study expands on the current body of evidence as more data are needed on the effect of this type of interventions not only on functional improvement but also through brain imaging to study the effect of the intervention on plasticity. (shrink)

Information and communication technologies , with their increasing and widespread utilization in daily life, may exert an important impact on brain performances. The development of their use for improving several cerebral processes, by abolishing the brain/machine interface, is envisaged and is subject to debate. The scientific research on brain implants and brain gene transfer aiming to restore central nervous system functions, altered by disease or trauma, may contribute to this debate. Indeed, the advances that are enabling (...) non drug-mediated approaches for direct interventions on the brain are raising the possibility not only of restoring neural functions for therapeutic purposes, but also of monitoring, controlling and ultimately modifying from the outside these functions for enhancement. This paper gives an overview of the state of the art of brain implants and brain gene transfer for neurological diseases with a particular emphasis on Parkinson’s disease and a forecast on their possible application for other conditions. In doing so, the authors, who are neuroscientists working in the field of gene transfer for neuropsychiatric diseases, aim to establish a scientifically, medically and technically realistic framework to open up discussion on relevant ethical issues in this domain. (shrink)

Besides the pure pleasure of watching a dance performance, dance as a whole-body movement is becoming increasingly popular for health-related interventions. However, the science-based evidence for improvements in health or well-being through dance is still ambiguous and little is known about the underlying neurophysiological mechanisms. This may be partly related to the fact that previous studies mostly examined the neurophysiological effects of imagination and observation of dance rather than the physical execution itself. The objective of this pilot study was to (...) investigate acute effects of a physically executed dance with its different components on the electrical brain activity and its functional connectivity using electroencephalographic analysis. Eleven dance-inexperienced female participants first learned a Modern Jazz Dance choreography over three weeks. Afterwards, the acute effects on the EEG brain activity were compared between four different test conditions: physically executing the MJD choreography with music, physically executing the choreography without music, imaging the choreography with music, and imaging the choreography without music. Every participant passed each test condition in a randomized order within a single day. EEG rest-measurements were conducted before and after each test condition. Considering time effects the physically executed dance without music revealed in brain activity analysis most increases in alpha frequency and in functional connectivity analysis in all frequency bands. In comparison, physically executed dance with music as well as imagined dance with music led to fewer increases and imagined dance without music provoked noteworthy brain activity and connectivity decreases at all frequency bands. Differences between the test conditions were found in alpha and beta frequency between the physically executed dance and the imagined dance without music as well as between the physically executed dance with and without music in the alpha frequency. The study highlights different effects of a physically executed dance compared to an imagined dance on many brain areas for all measured frequency bands. These findings provide first insights into the still widely unexplored field of neurological effects of dance and encourages further research in this direction. (shrink)

The profound changes in personality, mood, and other features of the self that neural interventions can induce can be disconcerting to patients, their families, and caregivers. In the neuroethical debate, these concerns are often addressed in the context of possible threats to the narrative self. In this paper, I argue that it is necessary to consider a dimension of impacts on the narrative self which has so far been neglected: neural interventions can lead to a loss of meaning of actions, (...) feelings, beliefs, and other intentional elements of our self-narratives. To uphold the coherence of the self-narrative, the changes induced by neural interventions need to be accounted for through explanations in intentional or biochemical terms. However, only an explanation including intentional states delivers the content to directly ascribe personal meaning, i.e., subjective value to events. Neural interventions can deprive events of meaning because they may favor a predominantly biochemical account. A loss of meaning is not inherently negative but it can be problematic, particularly if events are affected one was not prepared or willing to have stripped of meaning. The paper further examines what it is about neural interventions that impacts meaning by analyzing different methods. To which degree the pull towards a biochemical view occurs depends on the characteristics of the neural intervention. By comparing Deep Brain Stimulation, Prozac, Ritalin, psychedelics, and psychotherapy, the paper identifies some main factors: the rate of change, the transparency of the causal chain, the involvement of the patient, and the presence of an acute phenomenological experience. (shrink)

Working memory (WM) is a fundamental cognitive ability to support complex thought, but it is limited in capacity. WM training has shown the potential to make benefit for those in need. Many studies have shown the potential of transcranial direct current stimulation (tDCS) to transiently enhance WM performance by delivering low current to the brain cortex of interest via electrodes on the scalp. TDCS has also been revealed as a promising intervention to augment WM training in a (...) few studies. However, those few tDCS-paired WM training studies focused more on the effect of tDCS on WM enhancement and its transferability after training but paid less attention to the variation of cognitive performance during the training procedure. The current study attempted to explore the effect of tDCS on the variation of performance during WM training in healthy young adults. All the participant received WM training with the load-adaptive verbal N-back task for five days. During the training procedure, active/sham anodal high-definition tDCS (HD-tDCS) was used to stimulate the left dorsolateral prefrontal cortex (DLPFC). To examine the training effect, pre- and post-test were performed respectively one-day before and after the training sessions respectively. At the beginning of each training session, stable-load WM tasks were performed to examine the performance variation during training. Compared to the sham stimulation, higher learning rates of performance metrics during the training procedure were found when WM training was combined with active anodal HD-tDCS. The performance improvements (post-pre) of the active group were also found to be higher than those of sham group and were transferred to a similar untrained WM task. Further analysis revealed that the negative relation between the training improvements and baseline performance. These findings show the potential that tDCS may be leveraged as an intervention to facilitate WM training for those in need of higher WM ability. (shrink)

Research on human subjects aims to obtain knowledge of vital importance for human health and functioning. Neuroscientific research specifically is understood as oriented towards three goals: the maintenance of neurological health, the treatment of neurological diseases or syndromes, and the enhancement of neurological functioning. Most guidelines or regulations for pediatric research (whether in the U.S. or elsewhere) require that if a research intervention exposes subjects to more than minimal risk, a prospect of direct benefit is required—along with some (...) other important criteria. It is also required for any research project, that the methods and design will yield scientifically valid knowledge. This is typically met via placebo-controlled trials. This chapter presents an argument to the effect that more than minimal risk research on pediatric subjects cannot meet both ethical requirements. The basic idea is that either the subjects in the control or experimental arm will receive a prospect of direct benefit, but not both. This chapter also argues that the ethical weight or importance of this dilemma is very acute for neuroscientific research given the complexity of the brain’s functioning and the correlated difficulty of judging whether there is a “prospect” of direct benefit. The second half responds to this argument via a case study in neuroscientific research. The solution recapitulates a type of component analysis according to which different ethical principles apply to different activities of a research study. (shrink)

Traditional rehabilitation strategies become difficult in the chronic phase stage of stroke prognosis. Brain–computer interface combined with external devices may improve motor function in chronic stroke patients, but it lacks comprehensive assessments of neurological changes regarding functional rehabilitation. This study aimed to comprehensively and quantitatively investigate the changes in brain activity induced by BCI–FES training in patients with chronic stroke. We analyzed the EEG of two groups of patients with chronic stroke, one group received functional electrical stimulation rehabilitation (...) training and the other group received BCI combined with FES training. We constructed functional networks in both groups of patients based on direct directed transfer function and assessed the changes in brain activity using graph theory analysis. The results of this study can be summarized as follows: after rehabilitation training, the Fugl–Meyer assessment scale score was significantly improved in the BCI–FES group, and there was no significant difference in the FES group. Both the global and local graph theory measures of the brain network of patients with chronic stroke in the BCI–FES group were improved after rehabilitation training. The node strength in the contralesional hemisphere and central region of patients in the BCI–FES group was significantly higher than that in the FES group after the intervention, and a significant increase in the node strength of C4 in the contralesional sensorimotor cortex region could be observed in the BCI–FES group. These results suggest that BCI–FES rehabilitation training can induce clinically significant improvements in motor function of patients with chronic stroke. It can improve the functional integration and functional separation of brain networks and boost compensatory activity in the contralesional hemisphere to a certain extent. The findings of our study may provide new insights into understanding the plastic changes of brain activity in patients with chronic stroke induced by BCI–FES rehabilitation training. (shrink)

There are two main paradigms for brain-related science, with different implications for brain-focused intervention or advancement. The paradigm of homeostasis (“stability through constancy,” Walter Cannon), originating from laboratory-based experimental physiology pioneered by Claude Bernard, shows that living systems tend to maintain system functionality in the direction of constancy (or similitude). The aim of physiology is elucidate the factors that maintain homeostasis, and therapeutics aim to correct abnormal factor functions. The homeostasis paradigm does not formally recognize influences outside (...) its controlled experimental frames and it is variable in its modelling of neural contributions. The paradigm of allostatic orchestration (PAO) extends the principle of allostasis (“stability through change”) as originally put forth by Peter Sterling. The PAO originates from an evolutionary perspective and recognizes that biological set points change in anticipation of changing environments. The brain is the organ of central command, orchestrating cross-system operations to support optimal behavior at the level of the whole organism. Alternative views of blood pressure regulation and posttraumatic stress disorder illustrate differences between the paradigms. For the PAO, complexities of top-down neural effects and environmental context are foundational (not to be “factored out”), and anticipatory regulation is the principle of their interface. The allostatic state represents the integrated totality of brain-body interactions. Health itself is an allostatic state of optimal anticipatory oscillation, hypothesized to relate to the state of criticality, a mathematical point of poise between phases, on the border between order and disorder (or the “edge of chaos”). Diseases are allostatic states of impaired anticipatory oscillations, demonstrated as rigidifications of set points across the brain and body (disease comorbidity). Conciliation of the paradigms is possible, with “reactive homeostasis” resolved as an illusion stemming from anticipation of environmental monotony. Considerations are presented with respect to implications of the two paradigms for brain-focused intervention or advancement; the hypothesis that the state of criticality is a vehicle for evolutionary processes; concordance with a philosophy of freedom based on ethical individualism as well as self-creativity, non-obsolescence, empowerment, and citizenship; and concluding reflections on the science and ethics of the placebo, and the potential for virtuous cycles of brain-Anthropocene interactions. (shrink)

In the theoretical literature on moral responsibility, one sometimes comes across cases of manipulated agents. In cases of this type, the agent is a victim of wholesale manipulation, involving the implantation of various pro-attitudes (desires, values, etc.) along with the deletion of competing pro-attitudes. As a result of this manipulation, the agent ends up performing some action unlike any that she would have performed were it not for the manipulation. These sorts of cases are sometimes thought to motivate historical views (...) of responsibility, on which the agent’s past is relevant to whether she is responsible for a specific action. In a recent paper, Daniel Sharp and David Wasserman bring these theoretical discussions on moral responsibility to bear on practical issues regarding neurological modifications of individuals. After proposing and arguing for a historical view, Sharp and Wasserman offer some insight into how such a view may help us in determining the responsibility of subjects who have undergone Deep Brain Stimulation. This paper aims to join this discussion, by arguing that the correct historical view to be applied will also appeal to the agent’s control over her mental life and the fact that this was bypassed. I conclude with some brief comments on the practical implications of such a historical view. (shrink)

Transcranial magnetic stimulation can cause measurable effects on neural activity and behavioral performance in healthy volunteers. In addition, TMS is increasingly used in clinical practice for treating various neuropsychiatric disorders. Unfortunately, TMS-induced effects show large intra- and inter-subject variability, hindering its reliability, and efficacy. One possible source of this variability may be the spontaneous fluctuations of neuronal oscillations. We present recent studies using multimodal TMS including TMS-EMG, TMS-tACS, and concurrent TMS-EEG-fMRI, to evaluate how individual oscillatory brain state affects TMS (...) signal propagation within targeted networks. We demonstrate how the spontaneous oscillatory state at the time of TMS influences both immediate and longer-lasting TMS effects. These findings indicate that at least part of the variability in TMS efficacy may be attributable to the current practice of ignoring oscillatory fluctuations during TMS. Ignoring this state-dependent spread of activity may cause great individual variability which so far is poorly understood and has proven impossible to control. We therefore also compare two technical solutions to directly account for oscillatory state during TMS, namely, to use tACS to externally control these oscillatory states and then apply TMS at the optimal brain state, or oscillatory state-triggered TMS. The described multimodal TMS approaches are paramount for establishing more robust TMS effects, and to allow enhanced control over the individual outcome of TMS interventions aimed at modulating information flow in the brain to achieve desirable changes in cognition, mood, and behavior. (shrink)

The brain is an ever‐changing organ that encodes memories and directs behavior. Neuroanatomical studies have revealed structural plasticity of neural architecture, and advances in gene expression technology and epigenetics have demonstrated new mechanisms underlying the brain's dynamic nature. Stressful experiences challenge the plasticity of the brain, and prolonged exposure to environmental stress redefines the normative transcriptional profile of both neurons and glia, and can lead to the onset of mental illness. A more thorough understanding of normal and (...) abnormal gene expression is needed to define the diseased brain and improve current treatments for psychiatric disorders. The efforts to describe gene expression networks have been bolstered by microarray and RNA‐sequencing technologies. The heterogeneity of neural cell populations and their unique microenvironments, coupled with broad ranging interconnectivity, makes resolving this complexity exceedingly challenging and requires the combined efforts of single cell and systems level expression profiling to identify targets for therapeutic intervention. (shrink)

Most consumers are aware that climate change is a growing problem and admit that action is needed. However, research shows that consumers’ behavior often does not conform to their value and orientations. This value-behavior gap is due to contextual factors such as price, product design, and social norms as well as individual factors such as personal and hedonic values, environmental beliefs, and the workload capacity an individual can handle. Because of this conflict of interest, consumers have a hard time identifying (...) the true drivers of their behavior, as they are either unaware of or unwilling to acknowledge the processes at play. Therefore, consumer neuroscience methods might provide a valuable tool to uncover the implicit measurements of pro-environmental behavior (PEB). Several studies have already defined neurophysiological differences between green and non-green individuals; however, a behavior change intervention must be developed to motivate PEB among consumers. Motivating behavior with reward or punishment will most likely get users engaged in climate change action via brain structures related to the reward system, such as the amygdala, nucleus accumbens, and (pre)frontal cortex, where the reward information and subsequent affective responses are encoded. The intensity of the reward experience can be increased when the consumer is consciously considering the action to achieve it. This makes goal-directed behavior the potential aim of behavior change interventions. This article provides an extensive review of the neuroscientific evidence for consumer attitude, behavior, and decision-making processes in the light of sustainability incentives for behavior change interventions. Based on this review, we aim to unite the current theories and provide future research directions to exploit the power of affective conditioning and neuroscience methods for promoting PEB engagement. (shrink)

In this paper, we present a case of a boy – Noah Wall, who till today surprises the world of neuroscience with his will to grow his brain and survive. The case presented in this study sets a stepping stone in understanding the advent of the will to make a choice, from a neuro-quantum mechanics interpretation. We propose that besides our internal states of choices (neurogenesis, neuroplasticity, cell differentiation, etc.) we also relate with external states of choices (love, compassion, (...) empathy, emotions, etc.) that contributes to its emergence. Quantum uncertainty seems to support the existence of a fundamental property based on which the universe functions; which means that even the nothing of free space has a small chance of containing something. Outcomes are not determined by prior or random events but by consciousness that gives rise to these outcomes. This provides us a lead into understanding the existence of the will and the origin of choice when we look deeper into the realms of the implausible interpretations of quantum mechanics. Free will is the ability for the mind to choose between possible outcomes. Willful power is therefore not only a psychological intervention but also a biological and quantum intervention, where we have the capacity to make choices about what direction we will take, making a change to the systematic functioning of our body. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical (...) and moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

Anxiety disorders are among the most prevalent mental disorders. Present treatments such as cognitive behavior therapy and pharmacological treatments show only moderate success, which emphasizes the importance for the development of new treatment protocols. Non-invasive brain stimulation methods such as repetitive transcranial magnetic stimulation and transcranial direct current stimulation have been probed as therapeutic option for anxiety disorders in recent years. Mechanistic information about their mode of action, and most efficient protocols is however limited. Here the fear extinction (...) model can serve as a model of exposure therapies for studying therapeutic mechanisms, and development of appropriate intervention protocols. We systematically reviewed 30 research articles that investigated the impact of rTMS and tDCS on fear memory and extinction in animal models and humans, in clinical and healthy populations. The results of these studies suggest that tDCS and rTMS can be efficient methods to modulate fear memory and extinction. Furthermore, excitability-enhancing stimulation applied over the vmPFC showed the strongest potential to enhance fear extinction. We further discuss factors that determine the efficacy of rTMS and tDCS in the context of the fear extinction model and provide future directions to optimize parameters and protocols of stimulation for research and treatment. (shrink)

Pitting i-frame policies against s-frame policies inadvertently propagates a false dichotomy that fails to distinguish between effective i-frame policies that directly change behaviors and ineffective education-based i-frame policies that try to change people's hearts and minds. We argue that people's fixation on changing hearts and minds may be an obstacle for behavioral science in policy.

Attentional control theory (ACT) was proposed to account for trait anxiety’s effects on cognitive performance. According to ACT, impaired processing efficiency in high anxiety is mediated through inefficient executive processes that are needed for effective attentional control. Here we review the central assumptions and predictions of ACT within the context of more recent empirical evidence from neuroimaging studies. We then attempt to provide an account of ACT within a framework of the relevant cognitive processes and their associated neural mechanisms and (...) networks, particularly the fronto-parietal, cingular-opercula, and default mode networks. Future research directions, including whether a neuroscience-informed model of ACT can provide a platform for novel neurocognitive intervention for anxiety, are also discussed. (shrink)

Sociocultural developmental psychology can drive new directions in gadgetry science. We use autobiographical memory, a compound capacity incorporating episodic memory, as a case study. Autobiographical memory emerges late in development, supported by interactions with parents. Intervention research highlights the causal influence of these interactions, whereas cross-cultural research demonstrates culturally determined diversity. Different patterns of inheritance are discussed.

__Neurotechnology and Direct Brain Communication__ focuses on recent neuroscientific investigations of infant brains and of patients with disorders of consciousness, both of which are at the forefront of contemporary neuroscience. The prospective use of neurotechnology to access mental states in these subjects, including neuroimaging, brain simulation and brain computer interfaces, offers new opportunities for clinicians and researchers, but has also received specific attention from philosophical, scientific, ethical and legal points of view. This book offers the first (...) systematic assessment of these issues, investigating the tools neurotechnology offers to care for verbally non-communicative subjects and suggesting a multidisciplinary approach to the ethical and legal implications of ordinary and experimental practices. The book is divided into three parts: the first and second focus on the scientific and clinical implications of neurological tools for DOC patient and infant care. With reference to these developments, the third and final part presents the case for re-evaluating classical ethical and legal concepts, such as authority, informed consent and privacy. Neurotechnology and Direct Brain Communication will appeal to researchers and postgraduate students in the fields of cognitive science, medical ethics, medical technology, and the philosophy of the mind. With implications for patient care, it will also be a useful resource for clinicians, medical centres and health practitioners. (shrink)

There is concern that the use of neuroenhancements to alter character traits undermines consumer's authenticity. But the meaning, scope and value of authenticity remain vague. However, the majority of contemporary autonomy accounts ground individual autonomy on a notion of authenticity. So if neuroenhancements diminish an agent's authenticity, they may undermine his autonomy. This paper clarifies the relation between autonomy, authenticity and possible threats by neuroenhancements. We present six neuroenhancement scenarios and analyse how autonomy accounts evaluate them. Some cases are considered (...) differently by criminal courts; we demonstrate where academic autonomy theories and legal reasoning diverge and ascertain whether courts should reconsider their concept of autonomy. We argue that authenticity is not an appropriate condition for autonomy and that new enhancement technologies pose no unique threats to personal autonomy. (shrink)

This chapter will focus on the biomedical moral enhancement of offenders – the idea that we could modify offenders’ brains in order to reduce the likelihood that they would engage in immoral, criminal behaviour. Discussions of the permissibility of using biomedical means to address criminal behaviour typically analyse the issues from the perspective of medical ethics, rather than penal theory. However, recently certain theorists have discussed whether brain interventions could be legitimately used for punitive purposes. For instance, Jesper Ryberg (...) argues that there is nothing to prevent retributivists from endorsing brain interventions as a legitimate form of retributive punishment. Legal academics have not yet paid sufficient attention to whether this proposal would be compatible with international human rights law, nor have retributivist philosophers discussed whether their favoured penal theories have the conceptual resources to explain why brain interventions would not be an appropriate method of punishment. This chapter considers whether there is any indication that these interventions are being used at present for punitive purposes and whether this would violate the European Convention on Human Rights. It examines different versions of retributivism and considers which theory is in the best position to challenge the use of brain interventions as a form of punishment. Finally, it considers whether offering these interventions as an alternative to punishment would violate principles of proportionality. (shrink)

Addiction: A Philosophical Approach CHAPTER ABSTRACTS “Introduction: Dismantling the Catchphrase” by Candice Shelby Shelby dismantles the catchphrase “disease of addiction.” The characterization of addiction as a disease permeates both research and treatment, but that understanding fails to get at the complexity involved in human addiction. Shelby introduces another way of thinking about addiction, one that implies that is properly understood neither as a disease nor merely as a choice, or set of choices. Addiction is a phenomenon emergent from a complex (...) dynamic system that is at once physical, psychological, social, and more. “A Philosophical Analysis of Addiction” by Candice Shelby Shelby brings much-needed clarity to the discourse surrounding the topic of addiction. Arguing that addiction can neither properly be understood as a disease nor as merely a set of choices, Shelby exposes the weaknesses of both approaches. She shows that addicted persons do not exhibit the elements characteristic of compulsion, nor does an account of addiction in terms of weakness of will, or irrational choosing, provide a satisfying explanation. Instead, by replacing traditional substance ontology with process ontology, and accepting the reality of emergent entities, a coherent account of persons, minds, and addiction can be provided. A fundamental philosophical shift is necessary to see that bodies, minds, values, and addictions are all part of the natural world. “Addiction at the Individual Level” by Candice Shelby Shelby discusses the most influential accounts of addiction as it is understood at the purely individual level. From hedonic theories to incentive sensitization, to habit theories of addiction, to behavioral theories and the ego depletion theory, Shelby considers a variety of approaches to understanding addiction in individuals, as framed in both psychological and in neuroscientific terms. She notes some important caveats that should be considered before accepting the research regarding addiction at the individual level, namely that the scanning studies that are so popularly used to characterize addiction in neurobiological terms are ambiguous, and rely on numerous assumptions that may be false, and that certainly mislead. Shelby provides much-needed critique of both disease and choices models as they characterize addiction at the individual level. “Addiction and the Local Environment” by Candice Shelby Shelby argues that human addiction cannot be understood without serious consideration of the individual’s local environment, her home and family. From the gestational environment to interactions with caregivers during post-natal development to the adult environment in which people become addicted, Shelby shows that no one becomes an addict in a vacuum. Stress is a major influence in the environment throughout life, and has serious consequences for addictive vulnerability. Genetic influences as well are important to addictive vulnerability, but genes always express in interaction with their environment. Social acceptance or rejection is another particularly important factor in the local environment with respect to both coming to be addicted and transitioning out of it. “The Relation Between Addiction and Culture” by Candice Shelby Shelby provides a groundbreaking analysis of the relation between addicts and the cultures that breed them. In this cultural critique, Shelby shows that addictions to certain substances have historically been both the solution to the problem of how to grow economies and control people, and a problem for economic productivity and controlling citizens. Not all cultures have even the concept of addiction, while others, such as the contemporary Western world, and the U.S. in particular, seem to foster it. Shelby shows that addiction is both a cultural construct and, from another way of thinking about it, the result of conditions created by particular cultures. Social inequities, alienation, driving capitalism, and in particular the power of pharmaceutical companies, all contribute to the spiraling endemic of addiction. “Addiction and Meaning” by Candice Shelby Shelby provides a unique argument that understanding how meanings work is essential to a complete analysis of addiction. Individuals experiencing addiction and those who care about and for them often utterly fail to communicate. This is because their respective systems of meanings come to be significantly different. Meanings are not, Shelby argues, best understood in the symbolic terms that characterized the theory of language in the 20th century, but are better apprehended as emotion-rich prototypes carved from repeated interaction with the world. Becoming addicted essentially changes one’s entire system of meanings. Requisite to transitioning out of addiction is a Gestalt-type shift in one’s system of meanings. This holistic way of understanding meanings also provides one level of explanation of what happens when an addict relapses. “The Phenomenology of Addiction and its Implications” by Candice Shelby One way of judging theories of addiction is by how well they capture the phenomenal descriptions that addicts give of their own experiences. Shelby considers variations on 5 basic patterns of addictive experience through the eyes of particular individuals who lived through addictive periods, and shows how even the most influential theories of addiction fail to capture all of them. She argues that an important implication of taking the details of individuals’ addictive stories seriously is that addiction must be understood as a personal phenomenon emergent from a particular complex dynamic system. As her theory of addiction would lead one to expect, no two addicts are the same, and no single-focus theory can explain why not. “Possibilities for Transitioning Out of Addiction” by Candice Shelby Shelby provides numerous strategies for transitioning out of addiction. Given that the vast majority of addiction treatment programs currently available are 12-step based and only successful about 5-8% of the time, it is essential that other approaches be undertaken. Shelby canvasses a variety of options for helping addicted individuals to make the transition out of their troubled pattern of thinking and behaving. From direct brain interventions to drugs to trauma therapy to exercise and nutrition to habit reformation to use of narrative and changing one’s social context as ways of redefining the self, Shelby shows that the possibilities for transitioning out of addiction are legion. Perhaps the best approach is to understand addiction treatment in terms of providing physical, psychological, and social tool kits. “Addiction Emerges from a Complex Dynamic System” by Candice Shelby Shelby considers whether there truly exists such a thing as “an addict” or “addictive thinking” in the universal sense. She concludes that within the context of disruptive substance use or repetitive engagement in certain activities, ordinary human cognitive biases and behavior patterns are categorized as addictive. Addiction, she argues, is best understood as an irreducible human reality, emergent from a sufficiently complex dynamic system (an organism with self-awareness, within a particular cultural milieu) that is both shaped by and contributes to the shaping of its environment. Attempts to simplify addiction into one or a few dimensions may create a solvable problem, but by doing so they fail to solve the real one. (shrink)

This paper explores the impacts of neurological intervention on selfhood with reference to recipients’ claims about changes to their self-understanding following Deep Brain Stimulation for treatment of Parkinson’s Disease. In the neuroethics literature, patients’ claims such as: “I don’t feel like myself anymore” and “I feel like a machine”, are often understood as expressing threats to identity. In this paper I argue that framing debates in terms of a possible threat to identity—whether for or against the proposition, is (...) mistaken and occludes what is ethically salient in changes from DBS. Rather, by adopting a relational narrative approach to identity and autonomy, I show that the ethically salient issue from DBS is impacts on autonomous agency—whether one’s actions and beliefs are one’s own, and how DBS may hinder, or foster, embodied, relational autonomy competences. This approach recognizes that if sufficiently significant, impacts on autonomy competences may pose a threat to one’s ability to contribute to the process of authoring one’s own life and so pose a threat to identity formation. I argue this approach resolves the confusion in the literature about whether and how DBS threatens identity and provides a complex picture of how DBS may affect selfhood by disrupting narrative identity formation and revision, distorting agency and/or undermining autonomy. (shrink)

Under the current Mental Health Act of England and Wales, it is lawful to perform deep brain stimulation in the absence of consent and independent approval. We argue against the Care Quality Commission's preferred strategy of addressing this problematic issue, and offer recommendations for deep brain stimulation-specific provisions in a revised Mental Health Act.

This volume represents a comprehensive overview of the neuropsychology of emotion and the neural mechanisms underlying emotional processing. It draws on recent studies utilizing behavioral paradigms with normal subjects, the brain lesion approach, clinical evaluations of patients with neurological and psychiatric disorders, and neuroimaging techniques. The book opens with an introduction summarizing each chapter and pointing to directions for future research. The first section is on history, the neuroanatomy and neurophysiology of emotion, and techniques that have been widely used (...) to examine emotional processing- neuropsychological assessment and neuroimaging. Theoretical perspectives on emotion are offered next, including psychological, social-cognitive, neurobiological, and neuropsychological models. A set of chapters on the neural substrates of emotion deals with a spectrum of emotional conditions: elation and mania, sadness and depression, anxiety and stress, anger and impulsivity, and apathy and flat affect. The book concludes with clinical implications, including a description of emotional deficits in neurological and psychiatric disorders. Highlighted in this section is an overview of rehabilitative treatments and brain interventions for emotional processing deficits. This authoritative volume will be an important resource and text for neuropsychologists, clinical psychologists, speech-language pathologists, neuroscientists, psychiatrists, neurologists, rehabilitation specialists, and their students and trainees. (shrink)

The brain-in-a-vat argument for skepticism is best formulated, not using the closure principle, but using the “Preference Principle,” which states that in order to be justified in believing H on the basis of E, one must have grounds for preferring H over each alternative explanation of E. When the argument is formulated this way, Dretske’s and Klein’s responses to it fail. However, the strengthened argument can be refuted using a direct realist account of perception. For the direct (...) realist, refuting the SIV scenario is not a precondition on knowledge of the external world, and only the direct realist can give a non-circular account of how we know we’re not brains in vats. (shrink)

The brain-in-a-vat argument for skepticism is best formulated, not using the closure principle, but using the “Preference Principle,” which states that in order to be justified in believing H on the basis of E, one must have grounds for preferring H over each alternative explanation of E. When the argument is formulated this way, Dretske’s and Klein’s responses to it fail. However, the strengthened argument can be refuted using a direct realist account of perception. For the direct (...) realist, refuting the SIV scenario is not a precondition on knowledge of the external world, and only the direct realist can give a non-circular account of how we know we’re not brains in vats. (shrink)

The focus of this paper are the ethical, legal and social challenges for ensuring the responsible use of “big brain data”—the recording, collection and analysis of individuals’ brain data on a large scale with clinical and consumer-directed neurotechnological devices. First, I highlight the benefits of big data and machine learning analytics in neuroscience for basic and translational research. Then, I describe some of the technological, social and psychological barriers for securing brain data from unwarranted access. In this (...) context, I then examine ways in which safeguards at the hardware and software level, as well as increasing “data literacy” in society, may enhance the security of neurotechnological devices and protect the privacy of personal brain data. Regarding ethical and legal ramifications of big brain data, I first discuss effects on the autonomy, the sense of agency and authenticity, as well as the self that may result from the interaction between users and intelligent, particularly closed-loop, neurotechnological devices. I then discuss the impact of the “datafication” in basic and clinical neuroscience research on the just distribution of resources and access to these transformative technologies. In the legal realm, I examine possible legal consequences that arises from the increasing abilities to decode brain states and their corresponding subjective phenomenological experiences on the hitherto inaccessible privacy of these information. Finally, I discuss the implications of big brain data for national and international regulatory policies and models of good data governance. (shrink)