Neuroethics

Neuroethics refers to two related fields of study: what the philosopher Adina Roskies has called the ethics of neuroscience, and the neuroscience of ethics. The ethics of neuroscience comprises the bulk of work in neuroethics. It concerns the ethical, legal and social impact of neuroscience, including the ways in which neurotechnology can be used to predict or alter human behavior and 'the implications of our mechanistic understanding of brain function for society... integrating neuroscientific knowledge with ethical and social thought'. Neuroethics refers to two related fields of study: what the philosopher Adina Roskies has called the ethics of neuroscience, and the neuroscience of ethics. The ethics of neuroscience comprises the bulk of work in neuroethics. It concerns the ethical, legal and social impact of neuroscience, including the ways in which neurotechnology can be used to predict or alter human behavior and 'the implications of our mechanistic understanding of brain function for society... integrating neuroscientific knowledge with ethical and social thought'. Some neuroethics problems are not fundamentally different from those encountered in bioethics. Others are unique to neuroethics because the brain, as the organ of the mind, has implications for broader philosophical problems, such as the nature of free will, moral responsibility, self-deception, and personal identity. Examples of neuroethics topics are given later in this article ('Key issues in neuroethics'). The origin of the term 'neuroethics' has occupied some writers. Rees and Rose (as cited in 'References' on page 9) claim neuroethics is a neologism that emerged only at the beginning of the 21st century, largely through the oral and written communications of ethicists and philosophers. According to Racine (2010), the term was coined by the Harvard physician Anneliese A. Pontius in 1973 in a paper entitled 'Neuro-ethics of 'walking' in the newborn' for the Perceptual and Motor Skills. The author reproposed the term in 1993 in her paper for Psychological Report, often wrongly mentioned as the first title containing the word 'neuroethics'. Before 1993, the American neurologist Ronald Cranford has used the term (see Cranford 1989). Illes (2003) records uses, from the scientific literature, from 1989 and 1991. Writer William Safire is widely credited with giving the word its current meaning in 2002, defining it as 'the examination of what is right and wrong, good and bad about the treatment of, perfection of, or unwelcome invasion of and worrisome manipulation of the human brain'. Neuroethics encompasses the myriad ways in which developments in basic and clinical neuroscience intersect with social and ethical issues. The field is so young that any attempt to define its scope and limits now will undoubtedly be proved wrong in the future, as neuroscience develops and its implications continue to be revealed. At present, however, we can discern two general categories of neuroethical issue: those emerging from what we can do and those emerging from what we know. In the first category are the ethical problems raised by advances in functional neuroimaging, psychopharmacology, brain implants and brain-machine interfaces. In the second category are the ethical problems raised by our growing understanding of the neural bases of behavior, personality, consciousness, and states of spiritual transcendence. Primitive societies for the most part lacked a system of neuroethics to guide them in facing the problems of mental illness and violence as civilization advanced. Trepanation led through a tortuous course to 'psychosurgery'. Basic neuroscience research and psychosurgery advanced in the first half of the 20th century in tandem, but neuroscience ethics was left behind science and technology. Medical ethics in modern societies even in democratic governments, not to mention in authoritarian ones, has not kept pace with the advances of technology despite the announced social 'progress'; and ethics continues to lag behind science in dealing with the problem of mental illness in association with human violence. Unprovoked 'pathological' aggression persists, reminding us daily that civilization is a step away from relapsing into barbarism. Neuroscience ethics (neuroethics) must keep up with advances in neuroscience research and remain separate from state-imposed mandates to face this challenge. A recent writer on the history of psychosurgery as it relates to neuroethics concludes: 'The lessons of history sagaciously reveal wherever the government has sought to alter medical ethics and enforce bureaucratic bioethics, the results have frequently vilified medical care and research. In the 20th century in both the communist USSR and Nazi Germany, medicine regressed after these authoritarian systems corrupted the ethics of the medical profession and forced it to descend to unprecedented barbarism. The Soviet psychiatrists and Nazi doctor's dark descent into barbarism was a product of physicians willingly cooperating with the totalitarian state, purportedly in the name of the 'collective good', at the expense of their individual patients.' This must be kept in mind when establishing new guidelines in neuroscience research and bioethics. There is no doubt that people were thinking and writing about the ethical implications of neuroscience for many years before the field adopted the label 'neuroethics', and some of this work remains of great relevance and value. However, the early 21st century saw a tremendous surge in interest concerning the ethics of neuroscience, as evidenced by numerous meetings, publications and organizations dedicated to this topic. In 2002, there were several meetings that drew together neuroscientists and ethicists to discuss neuroethics: the American Association for the Advancement of Science with the journal Neuron, the University of Pennsylvania, the Royal Society, Stanford University, and the Dana Foundation. This last meeting was the largest, and resulted in a book, Neuroethics: Mapping the Field, edited by Steven J. Marcus and published by Dana Press. That same year, the Economist ran a cover story entitled 'Open Your Mind: The Ethics of Brain Science', Nature published the article 'Emerging ethical issues in neuroscience'. Further articles appeared on neuroethics in Nature Neuroscience, Neuron, and Brain and Cognition.