Current Ethical Issues in Neuroimaging

1. Current Ethical Issues in Neuroimaging • Adina Roskies • Dartmouth College Presentation to the Presidential Commission for the Study of Bioethical Issues, February 28, 2011

2. Neuroimaging • Primarily diagnostic, descriptive/predictive, non-interventional • Can be used in conjunction with interventional techniques like TMS, DBS which raise other ethical issues • “We are our brains” more immediate than “We are our genes”

3. Parallels with HGP ELSI • Many similar informational risks • Some differences: • potential to pose a different kind of privacy threat • consent issues • usually the information does not affect people other than subject • neurological cases often involve competence

4. Privacy/potential forensic uses of neuroimaging • Mental Content • MVPA allows prediction of visual content on basis of brain data (Mitchell et al, 2008, Shinkareva et al. 2008, Just et al. 2010) • Lie/truth detection • knowledge/familiarity • measures of arousal • measures of subjective but not objective familiarity (Rissman, Greely & Wagner, 2010) • pain

5. Mental Privacy, Lie detection • Techniques for assessing these better than chance, but: • experimental design problems • experimental confounds • unknown base rates (prevalence in the relevant population) • are apt to be misleading • All these provide only probabilistic information

6. Prediction • Prediction of brain disease • Potential forensic uses of predictive neuroimaging • Aggression/Antisocial behavior • Recidivism • Mental illness • Probabilistic information, no definitive predictions can currently be made • In many cases, we don’t know baserates

7. The ethics of consciousness • Recent developments in understanding/diagnosing disorders of consciousness • Mental imagery (Owen et al., 2006, Monti et al. 2010) • Trace conditioning (Bekinschtein et al., 2009) • Ethical implications of these developments for extending life, pain management, quality of life considerations • Underlying importance of considerations of welfare and autonomy

8. Responsibility and culpability • Biological picture puts pressure on commonsense notions of free will • Neuroscience puts pressure even a more sophisticated notion of free will (reasons-responsiveness) • How do we integrate the finding that biological factors affect ethical conduct with theories of responsibility? • Ethical issues arising from such understanding, including judgments of culpability, effects of interventions, ethics of interventions, etc.

9. Public (mis)understanding • General scientific literacy • Specific problems with understanding neuroimaging data • Mistaken beliefs in biological (genetic, neural) determinism • Lack of recognition of brain plasticity and its consequences • Lack of appreciation of extent of individual variation • Difference ≠ dysfunction or disease

10. Ethical questions • The ethics of privacy • The ethics of prediction • The nature and value of consciousness • Theory of responsibility commensurate with a scientific understanding of behavior • Consideration of the concepts of “authenticity” and “autonomy” and their connections to and relative priority regarding considerations of welfare and other values

11. Other important policy issues • Understanding range of individual variability is essential for proper interpretation of information, yet determination of such information not structurally encouraged • Responsible education of public and media