Neuroethics: the border between brain research and morality

 

Megan Shipman, a Ph.D. candidate in the UVM Neuroscience Graduate Program, writes:

I was first introduced to the term “neuroethics” at the Society for Neuroscience meeting that I attended this past fall. In a large lecture, Dr. Joseph J. Fins, a physician and ethicist from Cornell University, presented an ethically compelling case about a study on patients who were in vegetative states. This research involved the implantation of an electrode into the brains of patients to provide electrical stimulation to attempt to “wake” them up [1]. Naturally, this was fraught with ethical issues, primarily based around how the patients in vegetative states could not give consent to be research participants. Dr. Fins further described some of the ethical debates involved in this type of research: if participants cannot speak or express themselves in any way, how can we justify performing brain surgery on them? What if the new technology “wakes them up,” but cannot help them recover completely, thus simply making them more cognizant of their dire conditions? Where do we draw the line in determining the potential cost-benefit to the patient who is the research participant versus all patients with their condition? These difficult questions were presented while Dr. Fins compassionately discussed specific patients and their families’ journeys through these experiments that pushed the boundaries of ethics.

Neuroethics stems from the field bioethics, which deals with ethical issues that arise from biological and medical advances. One major element of bioethics involves patients’ rights and moral code within the medical field. Neuroethics is a narrower discipline that has developed to address similar issues specifically related to the brain. Not only does it deal with medical cases such as the research by Dr. Fins, but it also spans matters such as cognitive enhancement, culpability after brain injury, and privacy following brain scans [2]. I found its intertwinement with complex moral issues and my own graduate studies fascinating. In this blog post, I will discuss what I have learned since delving into neuroethics and present a brief sampling of issues that it seeks to address.

One major component of neuroethics is dealing with privacy. Within this realm, MRI scans are a hot topic. As we learn more about the brain, we are beginning to further understand what MRIs tell us about people’s characteristics. For instance, some studies have attempted to use fMRI as a means of lie detection, and found it somewhat successful [3]. In this regard, neuroethicists may contemplate whether or not it is ethical for an employer to require brain scans for employees with the intention to screen out candidates with a particular quality. First of all, should employers be allowed access to this information? Further, because believing that a potential employee is lying or test results that reveal an unsavory personality trait may be damaging, one important aspect of this debate involves determining the limitations of our knowledge. For example, neuroethicists might ask what the likelihood is that a false positive outcome will occur on an fMRI lie detection test. Additionally, they might question that, if an MRI reveals that someone has a “psychopath” brain profile, what are the chances that they are actually murderers? This example is especially relevant as one researcher, James Fallon, was confident in his understanding of psychopath brains, which show a reduction in particular areas correlated with empathy and morality, until he discovered that an image that looked particularly pathological was his own brain! Though he explains this as him having psychopathic characteristics, it serves as a cautious reminder that we can’t always assume behavior from biology [4]. As our understanding of the brain increases, so too does our need to understand and implement a means of protecting privacy. Are we confident enough that biology begets symptomology in complex mental disorders? Another element of this debate lies in whether or not we should be able to discriminate against people based on their brains. Knowing that someone is particularly truthful or empathetic might uniquely qualify them for certain careers. But how much privacy should people be allowed? If the brain could tell us everything about someone, how much should we read?

Another unique aspect of neuroethics deals with personality. The famous case of Phineas Gage exemplifies this topic. Gage, an organized, hardworking man, became temperamental and unreliable following an injury that put a hole through his frontal lobe. Cases like his lead us to contemplate what exactly makes a person who they are. This issue can relate heavily to neuroethics in cases where personality is altered by neurological damage, resulting in a behavior that is out of character and harmful. For instance, some recent court cases have struggled with this matter when a seemingly normal personal commits a violent crime and later evidence reveals some brain abnormality that developed, like a tumor or a cyst [5]. But, is it reasonable to blame a tumor for a murder? Shouldn’t a good person still be “in there” somewhere? The same question may also be asked of people who are addicted to drugs and commit a crime, or even people with a mental disorder who choose to stop medication at the risk of hurting themselves or others. This issue of culpability, like the issue of privacy, also gets at biological determinism. If we are our brains, then who are we if they are damaged? The rise of this new field raises more questions than answers, and many of these debates will continue to be points of contention.

During our time as graduate students, we are often presented with information concerning the ethics of our scientific research. Some of these may include methodological issues, avoiding being misleading with figures, not over-interpreting our results, and in delineating first authorship. Much less discussed are the ethical implications of our potential discoveries. Neuroethics has emerged as an essential parallel to our ever-increasing understanding of the brain with potential to inform policy and rulings in legal cases. Whether formally trained in neuroethics or not, it is essential for all neuroscientists to consider possible ethical dilemmas that may relate to their own research.

 

References

[1] [J. J. Fins]. [Giving Voice to Consciousness: Neuroethics, Human Rights, and the Indispensability of Neuroscience]. Program No. 277. 2015 Neuroscience Meeting Planner. Washington, DC: Society for Neuroscience, 2015. Online.

 [2] http://dana.org/Cerebrum/2004/Neuroethics__A_Guide_for_the_Perplexed/

 [3] Langleben, D. D., Hakun, J. G., Seelig, D., Wang, A.-L. L., Ruparel, K., Bilker, W. B., & Gur, R. C. (2016). Polygraphy and functional magnetic resonance imaging in lie detection: a controlled blind comparison using the concealed information test. The Journal of clinical psychiatry.

 [4] http://www.smithsonianmag.com/science-nature/the-neuroscientist-who-discovered-he-was-a-psychopath-180947814/?no-ist

[5]http://www.abajournal.com/magazine/article/brain_trials_neuroscience_is_taking_a_stand_in_the_courtroom/

 

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