Several authors in bioethics literature have expressed the view that a whole brain conception of death is philosophically indefensible. If they are right, what are the alternatives? Some authors have suggested that we should go back to the old cardiopulmonary criterion of death and abandon the so-called Dead Donor Rule. Others argue for a pluralist solution. For example, Robert Veatch has defended a view that competent persons should be free to decide which criterion of death should be used to determine (...) their death. However, there is very little data on people’s preferences about death determination criteria. We conducted online vignette-based survey with Latvian participants (N = 1416). The data suggest that the pluralist solution fits best with the way our study participants think about death determination—widely differing preferences concerning death determination criteria were observed. Namely, most participants choose one of the three criteria discussed in the literature: whole brain, higher brain, and cardiopulmonary. Interestingly, our data also indicate that study participants tend to prefer less restrictive criteria for determination of their own deaths than for determination of deaths of their closest relatives. Finally, the preferences observed in our sample are largely in accord with the Dead Donor Rule for organ procurement for transplantation. (shrink)

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

Brain-machine interfaces are a growing field of research and application. The increasing possibilities to connect the human brain to electronic devices and computer software can be put to use in medicine, the military, and entertainment. Concrete technologies include cochlear implants, Deep Brain Stimulation, neurofeedback and neuroprosthesis. The expectations for the near and further future are high, though it is difficult to separate hope from hype. The focus in this paper is on the effects that these new technologies may have on (...) our ‘symbolic order’—on the ways in which popular categories and concepts may change or be reinterpreted. First, the blurring distinction between man and machine and the idea of the cyborg are discussed. It is argued that the morally relevant difference is that between persons and non-persons, which does not necessarily coincide with the distinction between man and machine. The concept of the person remains useful. It may, however, become more difficult to assess the limits of the human body. Next, the distinction between body and mind is discussed. The mind is increasingly seen as a function of the brain, and thus understood in bodily and mechanical terms. This raises questions concerning concepts of free will and moral responsibility that may have far reaching consequences in the field of law, where some have argued for a revision of our criminal justice system, from retributivist to consequentialist. Even without such a (unlikely and unwarranted) revision occurring, brain-machine interactions raise many interesting questions regarding distribution and attribution of responsibility. (shrink)

Since its emergence in the early 2000s, neuroethics has become a recognized, institutionalized and professionalized field. A central strategy for its successful development has been the claim that it must be an autonomous discipline, distinct in particular from bioethics. Such claim has been justified by the conviction, sustained since the 1990s by the capabilities attributed to neuroimaging technologies, that somehow ‘the mind is the brain’, that the brain sciences can illuminate the full range of human experience and behavior, and that (...) neuroscientific knowledge will have dramatic implications for views of the human, and challenge supposedly established beliefs and practices in domains ranging from self and personhood to the political organization of society. This article examines how that conviction functions as neuroethics’ ideological condition of possibility. (shrink)

This article argues that a new diagram is emerging in the criminal justice system as it encounters developments in the neurosciences. This does not take the form that concerns many ‘neuroethicists’ — it does not entail a challenge to doctrines of free will and the notion of the autonomous legal subject — but is developing around the themes of susceptibility, risk, pre-emption and precaution. I term this diagram ‘screen and intervene’ and in this article I attempt to trace out this (...) new configuration and consider some of the consequences. (shrink)

The prospect of using cell-based interventions to treat neurological conditions raises several important ethical and policy questions. In this target article, we focus on issues related to the unique constellation of traits that characterize CBIs targeted at the central nervous system. In particular, there is at least a theoretical prospect that these cells will alter the recipients' cognition, mood, and behavior—brain functions that are central to our concept of the self. The potential for such changes, although perhaps remote, is cause (...) for concern and careful ethical analysis. Both to enable better informed consent in the future and as an end in itself, we argue that early human trials of CBIs for neurological conditions must monitor subjects for changes in cognition, mood, and behavior; further, we recommend concrete steps for that monitoring. Such steps will help better characterize the potential risks and benefits of CBIs as they are tested and potentially used for treatment. (shrink)

The growing area of military bio-technologies, especially the use of cogniceuticals, raises several ethical concerns for military physicians. These include the role of military physicians in prescr...

Mental health care providers increasingly confront challenges posed by the introduction of new neurotechnology into the clinic, but little is known about the impact of such capabilities on practice patterns and relationships with patients. To address this important gap, we sought providers’ perspectives on the potential clinical translation of functional neuroimaging for prediction and diagnosis of mental illness. We conducted 32 semi-structured telephone interviews with mental health care providers representing psychiatry, psychology, family medicine, and allied mental health. Our results suggest (...) that mental health providers have begun to re-conceptualize mental illness with a neuroscience gaze. They report an epistemic commitment to the value of a brain scan to provide a meaningful explanation of mental illness for their clients. If functional neuroimaging continues along its projected trajectory to translation, providers will ultimately have to negotiate its role in mental health. Their perspectives, therefore, enrich bioethical discourse surrounding neurotechnology and inform the translational pathway. (shrink)

As a relational concept, responsible innovation can be made more tangible by asking innovation of what and responsibility of whom for what? Arranging the scattered field of responsible innovation comprehensively, starting from an anthropological point of view, into five fields of tension and five categories of spearheads, may be theoretically and practically helpful while offering suggestions for both research and management.

Over the past decades, mood enhancement effects of various drugs and neuromodulation technologies have been proclaimed. If one day highly effective methods for significantly altering and elevating one’s mood are available, it is conceivable that the demand for them will be considerable. One urgent concern will then be what role physicians should play in providing such services. The concern can be extended from literature on controversial demands for aesthetic surgery. According to Margaret Little, physicians should be aware that certain aesthetic (...) enhancement requests reflect immoral social norms and ideals. By granting such requests, she argues, doctors render themselves complicit to a collective ‘evil’. In this paper, we wish to question the extent to which physicians, psychiatrists and/or neurosurgeons should play a role as ‘moral gatekeepers’ in dealing with suspect demands and norms underlying potential desires to alter one’s mood or character. We investigate and discuss the nature and limits of physician responsibilities in reference to various hypothetical and intuitively problematic mood enhancement requests. (shrink)

In his paper “The challenge of brain death for the sanctity of life ethic”, Peter Singer advocates two options for dealing with death criteria in a way that is compatible with efficient organ transplantation policy. He suggests that we should either redefine death as cortical death or go back to the old cardiopulmonary criterion and scrap the Dead Donor Rule. We welcome Singer’s line of argument but raise some concerns about the practicability of the two alternatives advocated by him. We (...) propose adding a third alternative that also – as the two previous alternatives – preserves and extends the possibility of organ transplantation without using anyone without their consent. Namely, we would like to draw readers’ attention to a proposal by Robert Veatch, formulated 42 years ago in his 1976 book “Death, dying, and the biological revolution” and developed further in his later publications. Veatch argues for a conscience clause for the definition of death that would permit people to pick from a reasonable range of definitional options. This autonomy-based option, we believe, is more likely to be practicable than the two options advocated by Singer. Furthermore, we present data from a study with Lithuanian participants that suggest that there is quite pronounced variation of preferences concerning death determination. (shrink)

Through the criminal justice system so-called dangerous offenders are, besides the offence that they are being convicted of and sentenced to, also punished for acts that they have not done but that they are believe to be likely to commit in the future. The aim of this paper is to critically discuss whether some adherents of retributivism give a plausible rationale for punishing offenders more harshly if they, all else being equal, by means of predictions are believed to be more (...) dangerous than other offenders. While consequentialism has no problem, at least in principle, with this use of predictions most retributivists have been opponents of punishing offenders on the basis of predictions. How can an offender deserve to be punished for something that he has not done? But some retributivists like Anthony Duff and Stephen Morse have argued in favor of punishing offenders who are considered to be dangerous in the future more harshly than non-dangerous offenders. After having reconstructed their arguments in detail, it will be argued that both Duff’s and Morse’s attempts to give a retributivistic justification have several shortcomings. (shrink)

I use a hypothetical case study of a woman who replaces here biological arms with prostheses controlled through a brain–computer interface the explore how a BCI might interpret and misinterpret intentions. I define pre-veto intentions and post-veto intentions and argue that a failure of a BCI to differentiate between the two could lead to some troubling legal and ethical problems.

Over the past few years, a number of authors in the new field of neuroethics have claimed that there is an ethical challenge presented by the likelihood that the findings of neuroscience will undermine many common assumptions about human agency and selfhood. These authors claim that neuroscience shows that human agents have no free will, and that our sense of being a “self” is an illusory construction of our brains. Furthermore, some commentators predict that our ethical practices of assigning moral (...) blame, or of recognizing others as persons rather than as objects, will change as a result of neuroscientific discoveries that debunk free will and the concept of the self. I contest suggestions that neuroscience’s conclusions about the illusory nature of free will and the self will cause significant change in our practices. I argue that we have self-interested reasons to resist allowing neuroscience to determine core beliefs about ourselves. (shrink)

Neuroethics is a dynamic and still rather young interdisciplinary field involving neuroscience, philosophy, or bioethics, among other academic specialties. It is under a process of institutionalization on a global scale, although not at the same pace in every country. Much literature has been devoted to the discussion of the purpose and relevance of neuroethics as a field, but few attempts have been made to analyze its local conditions of development. This paper describes the advancement of neuroethics in Japan as a (...) case study on the ups and downs of the institutionalization of a new academic field. As one of the peculiarities of neuroethics is the diversity of its constituent subject areas, which range from ethics of neuroscience to neuroscience of ethics, the analysis relies on a framework delineating its different aspects. The discussion of the Japanese case study is embedded in several interpretations of the significance of the field proposed by various actors, proponents, or detractors of neuroethics. The history of neuroethics in Japan can be read as a contribution to meta-neuroethics by those interested in definitions of neuroethics, and as a study in science policy by those interested in the Japanese system of research. (shrink)

A prominent concern in the literature on the ethics of human enhancement is that unequal access to future technology will exacerbate existing societal inequalities. The philosopher Daniel Wikler has argued that a futuristic cognitively enhanced majority would be justified in restricting the civil liberties of the unenhanced minority population for their own good in the same way that, mutatis mutandis, the cognitively normal majority are now justified in restricting the civil liberties of those deemed to be cognitively incompetent. Contrary to (...) this argument, the author of this manuscript presents and defends The Liberal Argument to Protect Cognitive ‘Normals’. According to this argument, while classical liberalism authorizes the cognitively competent to paternalistically restrict the civil liberties of the cognitively incompetent, classical liberalism does not authorize the cognitively enhanced to paternalistically restrict the civil liberties of the cognitively normal. Two additional arguments are developed in support of The Liberal Argument to Protect Cognitive ‘Normals’. The author of this manuscript concludes by suggesting that classical liberalism could be valuable for protecting the civil liberties of disenfranchised groups in a future in which enhancement technology could exacerbate existing societal inequalities. (shrink)

Our technologies have enabled us to change both the world and our perceptions of the world, as well as to change ourselves and to find new ways to fulfil the human desire for improvement and for having new capacities. The debate around using technology for human enhancement has already raised many ethical concerns, however little research has been done in how human enhancement can affect human communication. The purpose of this paper is to explore whether some human enhancements could change (...) our shared lifeworld so radically that human communication as we know it would not be possible any longer. After exploring the kinds of communication problems we are concerned with as well as mentioning some possible enhancement interventions that could bring about such problems, we will address some of the ethical implications that follow from these potential communication problems. We argue that because of the role that communication plays in human society, this issue deserves attention. (shrink)

Psychiatric inpatients with capacity may be treated paternalistically under the Mental Health Act 1983. This violates bodily autonomy and causes potentially significant harm to health and moral status, both of which may be long-lasting. I suggest that such harms may extend to killing moral persons through the impact of psychotropic drugs on psychological connectedness. Unsurprisingly, existing legislation is overwhelmingly disliked by psychiatric inpatients, the majority of whom have capacity. I present four arguments for involuntary treatment: individual safety, public safety, authentic (...) wishes and protection of autonomy. I explore these through a case study: a patient with schizophrenia admitted to a psychiatric hospital under the Mental Health Act 1983 after an episode of self-poisoning. Through its discussion of preventative detention, the public safety argument articulates the (un)ethical underpinnings of the current position in English law. Ultimately, none of the four arguments are cogent—all fail to justify the current legal discrimination faced by psychiatric inpatients. I conclude against any use of involuntary treatment in psychiatric inpatients with capacity, endorsing the fusion approach where only psychiatric patients lacking capacity may be treated involuntarily. (shrink)

This article consists of four parts. In the first part it briefly describes the history of body‐to‐head transplantation (BHT) and the surgical plan proposed by Drs. Sergio Canavero and Ren Xiaoping on a human subject. In the second part it argues that the BHT procedure that they propose is scientifically invalid and technically infeasible so therefore would end in failure. In the third part it argues that the present conceivable procedure of BHT cannot be ethically justified because it would bring (...) great harm to the human subject, it is uncertain who would be the possible beneficiary, and valid informed consent cannot be obtained. In the fourth part it argues that the action of performing the procedure of BHT might violate China’s current criminal and civil laws. The conclusion that follows from the arguments above is that BHT should be prohibited now and also in the near future. However, this conclusion does not preclude scientists, neurosurgeons and bioethicists doing research into scientific, technical, surgical and ethical issues raised by BHT. (shrink)

With the rapid progress and considerable promise of nanobiotechnology/neurosciences there is the potential of transforming the very nature of human beings and of how humans can conceive of themselves as rational animals through technological innovations. The interface between humans and machines (neuro-digital interface), can potentially alter what it means to be human, i.e., the very idea of human nature and of normal functioning will be changed. In this paper, I argue that we are potentially on the verge of a paradigm (...) shift in terms of the ends and goals of techno-science and its applications in the biomedical sciences. In particular, the development of brain-computer interfaces could reconceptualize the very notion of what it means to be human. Hence, we should not limit our reflections of applications in terms of therapy and enhancement but also include an examination of applications aiming at the alteration of human nature. To this end I will first delineate the potential paradigm shift and then map out four distinct clusters of concerns in relation to the brain-computer interface. Finally, I argue that our moral and philosophical reflections should follow a procedural model based on managed consensus due to our pluralistic context. (shrink)

In recent years, two distinct trajectories of bioethical inquiry have emerged: neuroethics and nanoethics. The former deals with issues in neuroscience, whereas the latter deals with issues in nanoscience and nanotechnology. In both cases, the ethical inquiries have coalesced in response to rapidly increasing scientific and engineering developments in each field. Both also present major issues for contemplation in bioethics. However, the questions are (1) how different are the ethical issues raised, and (2) is it beneficial for neuroethics and nanoethics (...) inquiries to proceed on often-divergent trajectories by ethicists who otherwise might never interact? If, for example, ethical inquiry occurs only within the disciplinary confines of their predominant area(s) of science (which now seems to be the case) or by overlooking prior discussions in other scientific realms (like genetics), then the opportunity for a richer, more comprehensive discourse may be lost. I argue that this (1) is a disservice to bioethics, (2) is antithetical to some of the aims of bioethical inquiry, and (3) encourages the reductionism bioethicists’ claim that is counterproductive. (shrink)