Essay: Neuroethics at Age 5


by Steven E. Hyman

May, 2014

Precisely because the brain lies at the center of our humanity and most valued capacities, brain diseases are particularly devastating and thus a focus of intense research efforts. While science is hard at work to defeat some of the cruelest conditions that afflict humankind, it is also providing important insights into human thought, emotion, and behavior, in health as well as illness. However, new technologies that permit us to observe the workings of the human brain and to influence its function also raise critical ethical and policy questions.

Advances in brain imaging have brought us closer to a time when we can make diagnoses objectively that today must rely on clinical observation alone. Advances in genetics and molecular biology give us hope that treatments can be developed, perhaps within a decade, that will slow the progress of neurodegenerative illnesses such as Alzheimer’s disease and Parkinson’s disease.

Along with genetics, advances in cognitive and social neuroscience suggest new approaches to schizophrenia and autism, with the goal of returning people to full heath and functioning. Progress at the interface of neuroscience with engineering points to a time when interactions between brain and computer will give meaningful motor control back to victims of paralysis. Early experiments with deep brain stimulation suggest that when we understand brain circuitry well enough, we may be able to better treat depression, anxiety disorders, and other ills affecting emotion and cognition.
Progress against diseases of the brain is and ought to be a central goal for our society. Progress will be hard-won because brains are so complex and because the highest levels of human cognition, for example, are not readily modeled in animals. But how to move more effectively against disease, how to engage the brightest young minds in the task, and how to give them the necessary tools are not the only challenges we face.

This year is the second time the Dana Alliance’s Progress Report on Brain Research has highlighted neuroethics (the first time was in 2003). Members of the Alliance have become deeply involved in writing and speaking on the ethical challenges that emerge from brain science. These concerns, emanating from the study of brain, behavior, and mental life, had been treated piecemeal in diverse venues, often in narrow communities of scientists, ethicists, and other scholars. A broad and lasting commitment to the questions that have been brought together under the term “neuroethics” was crystallized in a conference sponsored by the Dana Foundation in San Francisco entitled, “Neuroethics: Mapping the Field.”

Since that meeting in May 2002, a growing number of meetings, papers, and books have nurtured a vibrant interdisciplinary field with contributions from a diverse community that includes, among others, scientists, philosophers, physicians, lawyers, sociologists, political scientists, and policy makers. Given the growing interest, a group met in Asilomar, California, in May 2006 and decided to found a Neuroethics Society (www.neuroethicssociety.org).

The attendees at the Asilomar conference believed that a society would help form a platform to facilitate the kinds of sustained conversations that may help launch interdisciplinary fields in a way that permits scholars with different backgrounds to interact. Ever-increasing sophistication and depth, the thinking goes, will allow them to address critical problems.

This nascent society is hardly alone in bringing attention to the field. The American Association for the Advancement of Science has regularly featured neuroethics topics at its meetings. The Society for Neuroscience has featured a neuroethics lecture at its yearly conference since 2003 and has had three symposia on neuroethics, including one in October 2006 that focused on a wide range of international issues, from researchers educating volunteers and communities in poorer countries to wealthier governments formulating ethical guidelines as brain research progresses. This year the Cognitive Neuroscience Society and the Association for Psychological Science will feature symposia on neuroethics. The Wellcome Trust Bioethics Summer School has focused on neuroethics for the past two years. The American Academy of Arts and Sciences is planning a symposium on the use of neuroimaging in lie detection for early 2007.

Despite this growth, opportunities to publish are only now beginning to increase. New interdisciplinary fields often find difficulty in publishing for two reasons. First, the work may not align perfectly with the work of existing disciplines that control scholarly journals. Second, when a field requires significant contributions from multiple disciplines in order to succeed, finding relevant source material can be challenging. Neuroscientists, lawyers, and philosophers often do not know where to look in order to find articles dealing with problems in neuroethics.

Several efforts are therefore under way to provide venues for publication. The Neuroethics Society has formed an alliance with the American Journal of Bioethics to create special issues (American Journal of Bioethics–Neuroscience) dedicated to the field, and the Journal of Cognitive Neuroscience is expanding its coverage.
In these early days of neuroethics, one question that keeps emerging is why a new field is required at all. Why does the larger tent of bioethics not suffice? Of course, many scholars involved in neuroethics remain—and should remain—firmly rooted in existing bioethics activities. Many neuroethical concerns are central considerations of bioethics: informed consent given by individuals with cognitive impairment or end-of-life clinical issues, for example.
But brain research calls for something more. I believe that what is driving the emergence of neuroethics is the special status of the brain; a deep consideration of the implications of brain research pushes us well beyond the usual boundaries of bioethics.

The potential use of brain imaging to reconstruct a person’s recent experience or to investigate his or her veracity not only raises traditional bioethical questions of privacy but also engages broader communities—including law enforcement and national security experts—who are not often represented within discussions of bioethics.

The potential use of brain imaging to reconstruct a person’s recent experience or to investigate his or her veracity not only raises traditional bioethical questions of privacy but also engages broader communities—including law enforcement and national security experts—who are not often represented within discussions of bioethics.
Similarly, efforts to influence or control brain function only partly overlap with ethical concerns raised by attempts to alter the function of the heart or kidney. That is because the control of brain function goes to the core of our selfhood and autonomy. Even more unique to neuroethics is the recognition that the brain is not only the object of ethical study, but also the basis of our ethical principles.

This latter point is in itself contentious for those who believe that there is natural law or divine guidance on ethical principles. In a country such as the United States, in which religion is important, that discussion remains vital and significant. Moreover, as we begin to understand the neural foundations of social interaction including such issues as prejudice and trust, and as ways of influencing such interactions emerge (e.g., by pharmacology or electrical stimulation), profound questions arise about where our different ethical systems come from. Are they derived from timeless, rational principles, contingent products of an evolving brain, or both? If we are to handle scientific progress in the most adaptive way, neuroethics is here to stay.