Imaging or Imagining? A Neuroethics Challenge Informed by Genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point—even a backbone—for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

Imaging or imagining? A neuroethics challenge informed by genetics

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point--even a backbone--for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge.     

Ethical Concepts and Future Challenges of Neuroimaging: An Islamic Perspective

Neuroscience is advancing at a rapid pace, with new technologies and approaches that are creating ethical challenges not easily addressed by current ethical frameworks and guidelines. One fascinating technology is neuroimaging, especially functional Magnetic Resonance Imaging (fMRI). Although still in its infancy, fMRI is breaking new ground in neuroscience, potentially offering increased understanding of brain function. Different populations and faith traditions will likely have different reactions to these new technologies and the ethical challenges they bring with them. Muslims are approximately one-fifth of world population and they have a specific and highly regulated ethical and moral code, which helps them deal with scientific advances and decision making processes in an Islamically ethical manner. From this ethical perspective, in light of the relevant tenets of Islam, neuroimaging poses various challenges. The privacy of spirituality and the thought process, the requirement to put community interest before individual interest, and emphasis on conscious confession in legal situations are Islamic concepts that can pose a challenge for the use of something intrusive such as an fMRI. Muslim moral concepts such as There shall be no harm inflicted or reciprocated in Islam and Necessities overrule prohibitions are some of the criteria that might appropriately be used to guide advancing neuroscience. Neuroscientists should be particularly prudent and well prepared in implementing neuroscience advances that are breaking new scientific and ethical ground. Neuroscientists should also be prepared to assist in setting the ethical frameworks in place in advance of what might be perceived as runaway applications of technology.     

Neuroethics: an emerging new discipline in the study of brain and cognition

The vision for the special issue in Brain and Cognition is rooted in the need to bring to the foreground the state of scientific knowledge in research and clinical neuroimaging ethics. To this end, the issue highlights a broad range of relatively unexplored ethical challenges in functional neuroimaging with MR, alone or in combination with other neuroimaging modalities, from imaging the central nervous system of the fetus in utero through neural activation patterns associated with cognition and behavior in childhood and in adulthood. Theoretical, practical, and ethical considerations at the heart of imaging healthy research subjects and cognitively compromised patients are explored.     

Ethical issues in the application of medical technology to paediatric intensive care: two views of the newborn

Recent advances in medical technology have led to a marked improvement in the chances of survival of sick or preterm infants, thereby stimulating renewed ethical debate on the status of the newborn. Two contradictory attitudes to the medical care of preterm or congenitally malformed newborn infants can be discerned in our pluralistic society. The two attitudes have their historical roots in the classical Graeco-Roman and Judaeo-Christian ethical traditions respectively. The former views newborn infants as of potential value only whereas the latter emphasises the intrinsic worth and dignity of the individual made in God's image. Recent secular philosophical reflection has provided a rationale for infanticide of the sick or abnormal newborn. A Christian approach to the care of the newborn prohibits intentional killing yet may encompass the withdrawal of treatment that is inappropriate or unduly burdensome. Medical care should be based upon respect for the value of the individual, protection of the defenceless from abuse or exploitation, and wise stewardship of limited health-care resources.     

Flickering admissibility: neuroimaging evidence in the U.S. courts

This article explores the admissibility of neuroimaging evidence in U.S. courts, recognizing various trends in decisions about such evidence.While courts have routinely admitted some neuroimages, such as CT scans and MRI, as proof of trauma and disease, they have been more circumspect about admitting the PET and SPECT scans and fMRI evidence. With the latter technologies, courts have often expressed reservations about what can be inferred from the images. Moreover, courts seem unwilling to find neuroimaging sufficient to prove either insanity or incompetency, but are relatively lenient about admitting neuroimages in death penalty hearings. Some claim that fMRI and "brain fingerprinting" are able to detect deception. Other scholars argue that brain fingerprinting is a dubious concept and that fMRI is not yet sufficiently reliable. Moreover, there are substantial concerns about privacy and the perils of mind reading implicit in such technology. Yet, there is a movement to try to make these new technologies "courtroom ready" in the near future, raising a host of legal, policy, and ethical questions to be answered.     

Responsible Reporting: Neuroimaging News in the Age of Responsible Research and Innovation

Besides offering opportunities in both clinical and non-clinical domains, the application of novel neuroimaging technologies raises pressing dilemmas. ‘Responsible Research and Innovation’ (RRI) aims to stimulate research and innovation activities that take ethical and social considerations into account from the outset. We previously identified that Dutch neuroscientists interpret “responsible innovation” as educating the public on neuroimaging technologies via the popular press. Their aim is to mitigate (neuro)hype, an aim shared with the wider emerging RRI community. Here, we present results of a media-analysis undertaken to establish whether the body of articles in the Dutch popular press presents balanced conversations on neuroimaging research to the public. We found that reporting was mostly positive and framed in terms of (healthcare) progress. There was rarely a balance between technology opportunities and limitations, and even fewer articles addressed societal or ethical aspects of neuroimaging research. Furthermore, neuroimaging metaphors seem to favour oversimplification. Current reporting is therefore more likely to enable hype than to mitigate it. How can neuroscientists, given their self-ascribed social responsibility, address this conundrum? We make a case for a collective and shared responsibility among neuroscientists, journalists and other stakeholders, including funders, committed to responsible reporting on neuroimaging research.     

Ethical aspects of research into the etiology of autism

Advances in understanding autism and other developmental neuropsychiatric disorders will come from an integration of various research strategies including phenomenologic, functional neuroimaging, and pharmacologic methods, as well as epidemiologic approaches aimed at identifying genetic and environmental risk factors. The highly heritable nature of autism makes it scientifically valuable to involve parents and siblings as research participants. However, many studies on autism pose ethical challenges because they do not offer the prospect of direct benefit to subjects. In this article, we present an in-depth ethical analysis of current nontherapeutic research strategies that are common in autism research. The ethical analysis applies a proposed ethical framework for evaluating clinical research focusing on seven ethical requirements: (1) social or scientific value, (2) scientific validity, (3) fair subject selection, (4) favorable risk-benefit ratio, (5) independent review, (6) informed consent, and (7) respect for potential and enrolled research participants.     

Neuroimaging of emotion and personality: scientific evidence and ethical considerations

Affective neuroscience has seen an explosion of research efforts using modern neuroimaging approaches to uncover the neural basis of emotion and personality. The first section of this paper reviews studies from the domains of affective and forensic neuroimaging. These studies illustrate some of the topics likely to be the subject of future ethical debates. The second section relates limitations of the neuroimaging approach to ethical considerations in predicting future psychopathology on the basis of brain state analysis.     

Ethics of neuroimaging in pediatric development

Neuroimaging in pediatrics is accompanied by all the ethical dilemmas associated with neuroimaging in adults, magnified significantly. The defining characteristics of childhood make working ethically with the population particularly problematic. Children have not developed the rational capabilities necessary to make informed decisions and the variability and change associated with development contribute to heightened risks and/or benefits of any procedure and limit interpretation of data. As a consequence, fewer pediatric than adult neuroimaging research studies have been done, further limiting general knowledge of the field. Significant strides have been made just within the past few years with the collection of normative data sets of healthy children. Recommendations on how to proceed with pediatric neuroimaging studies while ensuring ethical treatment of the participants are presented.     

Compassion, consensus, and conflict: should caregivers' needs influence the ethical dialectic?

There are three important principles to be derived from this case. First, it is essential not to confound the technical problem of assessing pain and suffering with the ethical issue of judgments about pain and suffering. Second, in most cases, the apparent limitations of traditional ethical theory in critical care decisions are precisely that: apparent limitations only. The alternatives, especially intuitionism, are far more troublesome. Finally, the claim of health-care workers to be professionals places legitimate constraints on the extent to which they may be permitted to have their needs and wants influence the ethical dialectic. The achievement and maintenance of "comfortable, compatible relationships" cannot be legitimately construed as a major objective of biomedical ethics--although one would hope it will become a cherished, if serendipitous, byproduct. In short, paraphrasing (and reversing) Archibald MacLeish on poetry: Ethics should not be/but mean.     

What’s Different,Ethically, About Nanotechnology?: Foundational Questions and Answers

Whether nanotechnology is ethically unique and “nanoethics” should be treated as a field in its own right remain important, contested issues. This essay seeks to contribute to the debates on these issues by exploring several foundational questions about the relationship of ethics and nanotechnology. Ethical issues related to nanotechnology exist and adoption of a defeasible presumption that such issues amount to old ethical wine in new technological bottles appears justified. Such issues are not engendered solely by intrinsic features of the nanotechnology field, but also by contingent features of the social contexts in which work in the field unfolds. The sets of factors that engender ethical issues related to nanotechnology are combinations of social-contextual and technical elements. While there do not appear to be any qualitatively new nanotechnology-related ethical issues, nanotechnology is different, ethically, from other fields of technical inquiry in at least two ways. To avoid diluting ethical concern about nanotechnology and revival of the noxious notions of autonomous technology and technological determinism, thinking, writing, and speaking about ‘nanoethics’ should yield to thinking, writing, and speaking about ‘ethical issues related to nanotechnology in society.’ Finally, nanotechnology practitioners should become familiar with the ethical dimension of their work.     

CRISPR/Cas9 genome editing – new and old ethical issues arising from a revolutionary technology

Although germline editing has been the subject of debate ever since the 1980s, it tended to be based rather on speculative assumptions until April 2015, when CRISPR/Cas9 technology was used to modify human embryos for the first time. This article combines knowledge about the technical and scientific state of the art, economic considerations, the legal framework and aspects of clinical reality. A scenario will be elaborated as a means of identifying key ethical implications of CRISPR/Cas9 genome editing in humans and possible ways of dealing with them. Unlike most other discussions of CRISPR/Cas9 germline editing, which are generally based on deontological arguments, the focus in this case will be on a consequentialistic argument against certain applications of germline and somatic editing that takes not only the potential benefits and risks but also socioeconomic issues into consideration. The practical need for an indication catalogue, guidelines for clinical trials, and for funding of basic research will be pointed out. It will be argued that this need for regulatory action and discussion does not stem primarily from the fact that CRISPR/Cas9 germline editing is revolutionary in terms of its ethical implications and potential for human therapy, although this is the prevailing view in the current discussion. Understanding the value and interest dependency of arguments put forward by different stakeholders and learning from past debates related to similar technologies might prove a fruitful method of reaching judgments and decisions that come closer to a consensus upon which society as a whole can agree - which after all should be the true goal of an ethical debate and of bioethics.     

Discernment and Denial: Nanotechnology Researchers’ Recognition of Ethical Responsibilities Related to Their Work

To what extent do nanotechnology researchers discern specific work-related ethical responsibilities that are incumbent upon them? A questionnaire was designed and administered to answer this question. Analysis of responses to 11 ethical responsibility statements (ERSs) by 213 researchers at the Stanford Nanofabrication Facility revealed widespread agreement about a number of work-related ethical responsibilities and substantial divergence in the views about several others. Explanations of this divergence are proposed. A new variable is defined that gauges the respondent’s overall level of discernment of the ethical responsibilities referenced in the ERSs. The mean discernment level score for respondents who had taken a course that included discussion of ethical issues closely related to science, technology, or engineering was significantly higher than for those who had not. Further, among respondents who had taken such a course, the mean discernment level score for those who had taken an ethics course devoted to exploration of ethical issues closely related to science, technology, or engineering was significantly higher than for those who had taken a technical science or engineering course that typically pays only fleeting attention to such issues. Implications of these findings are discussed.     

The Limitations and Potential of Neuroimaging in the Criminal Law

Neuroimaging showing brain abnormalities is increasingly being introduced in criminal court proceedings to argue that a defendant could not control his behavior and should not be held responsible for it. But imaging has questionable probative value because it does not directly capture brain function or a defendant’s mental states at the time of a criminal act. Advanced techniques could transform imaging from a coarse-grained measure of correlations between brain states and behavior to a fine-grained measure of causal connections between them. Even if this occurs, bias and other attitudes may unduly influence jurors’ interpretation of the data. Moreover, judges’ decisions about whether neuroimaging data is legally relevant and admissible are normative decisions based on more than empirical evidence. Advanced neuroimaging will better inform assessments of criminal responsibility but will not supplant or explain away the psychological and normative foundation of the criminal law.     

Legal and ethical issues in neuroimaging research: human subjects protection,medical privacy,and the public communication of research results

Humans subjects research entails significant legal and ethical obligations. Neuroimaging researchers must be familiar with the requirements of human subjects protection, including evolving standards for the protection of privacy and the disclosure of risk in "non-therapeutic" research. Techniques for creating veridical surface renderings from volumetric anatomical imaging data raise new privacy concerns, particularly under the federal medical privacy regulation. Additionally, neuroimaging researchers must consider their obligation to communicate research results responsibly. The emerging field of neuroethics should strive to raise awareness of these issues and to involve neuroimaging researchers in the legal, ethical, and policy debates that currently surround human subjects research.     

Proposed Strategies for Teaching Ethics of Nanotechnology

Nanotechnology and nanosciences have recently gained tremendous attention and funding, from multiple entities and directions. In the last 10 years the funding for nanotechnology research has increased by orders of magnitude. An important part that has also gained parallel attention is the societal and ethical impact of nanotechnology and the possible consequences of its products and processes on human life and welfare. Multiple thinkers and philosophers wrote about both negative and positive effects of nanotechnology on humans and societies. The literature has a considerable amount of views about nanotechnology that range from calling for the abandonment and blockage of all efforts in that direction to complete support and encouragement in hopes that nanotechnology will be the next big jump in ameliorating human life and welfare. However, amidst all this hype about the ethics of nanotechnology, relatively less efforts and resources can be found in the literature to help engineering professionals and educators, and to provide practical methods and techniques for teaching ethics of nanotechnology and relating the technical side of it to the societal and human aspect. The purpose of this paper is to introduce strategies and ideas for teaching ethics of nanotechnology in engineering in relation to engineering codes of ethics. The paper is neither a new philosophical view about ethics of nanotechnology nor a discussion of the ethical dimensions of nanotechnology. This is an attempt to help educators and professionals by answering the question of how to incorporate ethics of nanotechnology in the educational process and practice of engineering and what is critical for the students and professionals to know in that regard. The contents of the presented strategies and ideas focus on the practical aspects of ethical issues related to nanotechnology and its societal impact. It also builds a relation between these issues and engineering codes of ethics. The pedagogical components of the strategies are based on best-practices to produce independent life-long self-learners and critical thinkers. These strategies and ideas can be incorporated as a whole or in part, in the engineering curriculum, to raise awareness of the ethical issues related to nanotechnology, improve the level of professionalism among engineering graduates, and apply ABET criteria. It can also be used in the way of professional development and continuing education courses to benefit professional engineers. Educators and institutions are welcome to use these strategies, a modified version, or even a further developed version of it, that suits their needs and circumstances.     

Should we design our descendants?

Rapid breakthroughs in genetic research spurred by the Human Genome Project, advances in molecular biology, and new reproductive technologies are raising the prospect that we may eventually have the technical capacity to modify genes that are transmitted to future generations not only to treat or eliminate diseases but also to "enhance" normal human characteristics beyond what is necessary to sustain or restore good health. This paper explores the ethical and justice implications of such genetic modifications. It argues against developing these technologies primarily because it will not be possible to counter the deleterious justice impacts. It recommends the need for public education and public discussion, preferably with the religious community taking an active role, to shape decisions about future genetic research and applications, and for better regulation of genetic technologies with the potential for inheritable genetic alterations.     

Animal ethical evaluation: an observational study of Canadian IACUCs

Three Canadian institutional animal care and use committees were observed over a 1-year period to investigate animal ethical evaluation. While each protocol was evaluated, the observer collected information about the final decision, the type of protocol (research vs. teaching), and the category of invasiveness. The observer also wrote down verbatim all verbal interventions, which were coded according to the following categories: scientific, technical, politics, human analog, reduction, refinement, and replacement. The data revealed that only 16% of the comments were devoted to the 3 explicit ethical categories (i.e., reduction, refinement, and replacement) and that most of the comments were technical. However, the analysis revealed that ethical concerns were implicit in both scientific and technical language, or some of the scientific and technical comments had an impact on the ethical treatment of animals. The results are discussed in relation to previous nonobservational research that identified potential pitfalls and bias in animal ethical evaluation.