Neuroethics: What is it and what comes next?

1. Neuroethics: What is it and what comes next? Françoise Baylis, PhD; Professor Canada Research Chair in Bioethics and Philosophy

2. Neuroethics: What is it? • ‘the study of the ethical, legal and social questions that arise when scientific findings about the brain are carried into medical practice, legal interpretations and health and social policy.’ Marcus D. (2002) Neuroethics: Mapping the field conference proceedings, May 13-14 2002, San Francisco, California. New York: The Dana Press.

3. Neuroethics: What is it? • Neuroethics encompasses a wide array of ethical issues emerging from different branches of clinical neuroscience (neurology, psychiatry, psychopharmacology) and basic neuroscience (cognitive neuroscience, affective neuroscience). • These include ethical problems raised by advances in functional neuroimaging, brain implants and brain-machine interfaces and psychopharmacology as well as by our growing understanding of the neural bases of behavior, personality, consciousness, and states of spiritual transcendence. http://neuroethics.upenn.edu/

4. Neuroethics: What is it? • “Neuroethics is more than just bioethics for the brain. [It] is the examination of how we want to deal with the social issues of disease, normality, mortality, lifestyle, and the philosophy of living informed by our understanding of underlying brain mechanisms" "It is—or should be—an effort to come up with a brain-based philosophy of life.” Gazzaniga, M. S. (2005). The Ethical Brain. The Dana Press.

5. Basic and clinical neuroscience UnderstandingNormalizing Enhancing Controlling

6. Basic and clinical neuroscience UnderstandingNormalizing Enhancing Controlling • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control

7. Basic and clinical neuroscience UnderstandingNormalizing Enhancing Controlling • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control • Cognition • Memory • Perception • Creativity • Attention • Empathy • Motor control • Self-control

8. Basic and clinical neuroscience Understanding Normalizing Enhancing Controlling • ‘Healthy’ minds and brains (consciousness/cognition) • Pathological mental functioning • Mood • Coma (brain activity but no consciousness) • Vegetative State • Minimally Conscious State (apparent fixation) • Locked-in

9. Basic and clinical neuroscience UnderstandingNormalizing Enhancing Controlling • ‘Healthy’ • Pathological • Mood • Coma • Vegetative • Minimally Conscious • Locked-in • Alleviate suffering, disability, risk of suicide • Reduce/eliminate motor disorders • Enable communication • Facilitate independent living outside psychiatric institution

10. Basic and clinical neuroscience UnderstandingNormalizing Enhancing Controlling • Improve performance • Provide a competitive advantage • Suffering • Motor disorders • Communication • Independence • ‘Healthy’ • Pathological • Mood • Coma • Vegetative • Minimally Conscious • Locked-in

11. Basic and clinical neuroscience UnderstandingNormalizing Enhancing Controlling • Performance • Competition • Limits on freedom • Freedom to re-invent the self • Volitional cognition • Transformative cognition • Suffering • Motor disorders • Communication • Independence • ‘Healthy’ • Pathological • Mood • Coma • Vegetative • Minimally Conscious • Locked-in

12. Systems, goals, interests … UnderstandingNormalizing Enhancing Controlling • Healthy • Fit to stand trial • Attentiveness • Eligibility criteria • Capabilities • Better than well • Excel in school and at work • Non-medical screening and surveillance • Tranhumanism • Military Industrial Complex • Neuromarketing • Health care • Law • Education • Insurance • Workplace • Military • Marketing

13. Pain and suffering UnderstandingNormalizing Enhancing Controlling • Reduce pain and suffering to range of normal • Increase tolerance for pain and suffering beyond range of normal • Eliminate experience of pain and suffering • Inflict pain and suffering • When does nociceptive activity begin? • What is pain the perception of? • Do fetuses experience pain? • What are the limits on tolerance for pain?

14. Psychopharmaceuticals UnderstandingNormalizing Enhancing Controlling • ADHD • Parkinson’s • Deep depression • Attentiveness • Memory • Wakefulness • Creativity • New ‘self’ • Truth serum • Induced coma • Mind expansion • Brain chemistry • Effects of recreational/ prescription drugs • Safety and efficacy of dosages

15. Brain imaging:Understanding our desires and vulnerabilities Understanding Normalizing Enhancing Controlling • fMRI and other noninvasive techniques for tracing neural activity (measuring psychological states and traits) to evaluate and predict complex human behavior • How are brain structures involved in higher functions (e.g., social attitudes, human cooperation and competition, emotion, and religious experience)?

16. Brain imaging:Understanding our desires and vulnerabilities Understanding Normalizing Enhancing Controlling • Privacy -- Employers, marketers, and the government may want information about an individual’s abilities, personality, truthfulness and other mental states. How can/will the privacy of one’s thoughts be assured? • Free will – How will neuroimaging change our notions of responsibility?

17. Brain imaging:Understanding our desires and vulnerabilities Understanding Normalizing Enhancing Controlling • Neuromarketing: brain imaging to measure limbic system response to a product to assess product preferences • Brain Fingerprinting: brain-based lie detection • Brainotyping: neuroimaging to learn about mental health vulnerabilities and predilection for violent crime • The ethics of neuroimaging and the neuroimaging of ethics (ie, ethical reasoning and behavior)

18. Brain Imaging:Understanding ethics Understanding Normalizing Enhancing Controlling • What can neuroimaging tell us about the nature of morality? • Can neuroimaging decide between competing ethical theories? • How will neuroimaging change our notions of responsibility? • Prediction and privacy in the neurodiagnostics

19. Psychopharmaceuticals: enhancing cognition Understanding Normalizing Enhancing Controlling • Chemical manipulation to improve brain functioning in healthy individuals (improving memory, attention, problem-solving through the use of pharmacological agents) • Methylphenidate (Ritalin) and modafinil (Provigil) are available through the Internet; used to improve cognitive performance (e.g., study aid)

20. Psychopharmaceuticals: enhancing cognition Understanding Normalizing Enhancing Controlling WHY? • To counter the effects of jet lag, shift work, monotonous activities, sleep deprivation, old age, etc. • To increase productivity and safety in the workplace. • To compensate for disadvantaged educational background. • To gain a competitive advantage.

21. Psychoharmaceuticals: enhancing cognition Understanding Normalizing Enhancing Controlling • Safety -- What might be the long-term health consequences? How will (should) these be weighed against immediate tangible benefits? • Access – What if cognitive enhancement is only available to the wealthy? The chemical ‘haves’ and ‘have-nots’ • Coercion -- What if cognitive enhancement is forced on individuals unwilling to consent (e.g., to improve competence to stand trial; to give children the edge at school)? What if pharmacological enhancement becomes the norm (social pressure) and is thus ‘required’ for success?

22. Psychopharmaceuticals: enhancing cognition Understanding Normalizing Enhancing Controlling • Identity – How might the drugs alter character and undermine authenticity, or, alternatively enhance sense of self? • Free will – How might this degrade personal responsibility for poor performance or antisocial behaviour (e.g., as when self-control comes from a pill)?

23. Neuroethics: What comes next? • What are the challenges and implications of “volitional cognition” – where our brains choose how our brains are to work? • What of “transformative cognition” – where the marketplace, social forces, competition, and their embedded values “choose” how our brains are to work?

24. Neuroethics: What comes next? • Constructing cognition • New self • New species • New world • Utopia • Dystopia