Background Transcranial direct current stimulation (tDCS) is a brain stimulation technique currently being researched as an alternative or complimentary treatment for various neurological disorders. There is little knowledge about experiences of the participants of tDCS clinical research, especially from pediatric studies. Methods An interview study with typically developing minors (n = 19, mean age 13,66 years) participating in a tDCS study, and their parents (n = 18) was conducted to explore their views and experiences and inform the ethical analysis. Results (...) Children (10–13 years old) and adolescents (14–18 years old) reported good experiences with the stimulation. Next to financial incentives, main motives to participate in the study were curiosity and the possibility to help develop treatments for children affected by neurological disorders. They could also see a potential of using tDCS in a non-medical setting, especially regarding the provision of equal opportunity, e.g. in education. Parents also presented a positive attitude towards tDCS and their children participation in the basic research study. Nevertheless, their understanding of tDCS was rather poor. Even though many of them understood the techniques, they often did not see the link between the (current) lack of side effects and an absence of longitudinal studies. Parents were also cautious about using tDCS for non-medical/enhancement purposes. Conclusions The study findings show a need for more transparent information about the state of the art of tDCS, its function and what it might be able to offer, especially considering the good acceptability of tDCS. (shrink)

What are the effects of circumcision on sexual function and experience? And what does sex—in the sense related to gender—have to do with the ethics of circumcision? Jacobs and Arora (2015) give short shrift to the first of these questions; and they do not seem to have considered the second. In this commentary, I explore the relationship between sex (in both senses) and infant male circumcision, and draw some conclusions about the ongoing debate regarding this controversial practice.

The moral enhancement (or bioenhancement) debate seems stuck in a dilemma. On the one hand, the more radical proposals, while certainly novel and interesting, seem unlikely to be feasible in practice, or if technically feasible then most likely imprudent. But on the other hand, the more sensible proposals – sensible in the sense of being both practically achievable and more plausibly ethically justifiable – can be rather hard to distinguish from both traditional forms of moral enhancement, such as non-drug-mediated social (...) or moral education, and non-moral forms of bioenhancement, such as smart-drug style cognitive enhancement. In this essay, I argue that bioethicists have paid insufficient attention to an alternative form of moral bioenhancement – or at least a likely candidate – that falls somewhere between these two extremes, namely the (appropriately qualified) use of certain psychedelic drugs. (shrink)

Male circumcision—partial or total removal of the penile prepuce—has been proposed as a public health measure in Sub-Saharan Africa, based on the results of three randomized control trials showing a relative risk reduction of approximately 60 per cent for voluntary, adult male circumcision against female-to-male human immunodeficiency virus transmission in that context. More recently, long-time advocates of infant male circumcision have argued that these findings justify involuntary circumcision of babies and children in dissimilar public health environments, such as the USA, (...) Australasia and Europe. In this article, we take a close look at the necessary ethical and empirical steps that would be needed to bridge the gap between the African RCTs and responsible public health policy in developed countries. In the course of doing so, we discuss some of the main disagreements about the moral permissibility of performing a nontherapeutic surgery on a child to benefit potential future sexual partners of his. In this context, we raise concerns not only about weaknesses in the available evidence concerning such claims of benefit, but also about a child’s moral interest in future autonomy and the preservation of his bodily integrity. We conclude that circumcision of minors in developed countries on public health grounds is much harder to justify than proponents of the surgery suggest. (shrink)

Transcranial direct current stimulation (tDCS) is a brain stimulation technique known for its relative safety and minimal invasiveness. tDCS has demonstrated efficacy as a potential treatment for certain neurological disorders, such as Parkinson’s disease, and has been shown to enhance a range of cognitive abilities under certain contexts. As a result, this technique has captured the interest of both the research community and the public at large. However, efforts to gather information about the effects of tDCS on the brain are (...) still in their infancy, leading to concerns about informed consent as it pertains to the possible risks associated with tDCS treatment. The ability to purchase tDCS equipment in the form of commercial, direct-to-consumer devices, generates even more cause for ethical concern, given the unknowns surrounding this technology and its potential broader societal impact. Previous research has touched on the many ethical issues raised by the emergence of this technology, including under what circumstances its use is justifiable and appropriate. In this paper, we survey recent normative and empirical works pertaining to the ethics of tDCS with the goal of summarizing the current state of ethical debate surrounding its use in the contexts of both therapy and cognitive enhancement, with a particular emphasis on the latter. Our analysis of the collected research finds that issues pertaining to user safety are paramount within existing scholarship; that tDCS use in children is an emerging area of concern entailing special considerations; and that regulatory bodies and legal agencies have struggled to implement appropriate, impactful regulation pertaining to tDCS and related technologies in order to balance public welfare against individual autonomy. This analysis will facilitate future efforts to develop bioethical approaches to tDCS by highlighting the ethical dimensions of tDCS prioritized in existing literature and identifying areas where further ethical consideration is needed. (shrink)

In this chapter, we introduce the notion of “moral neuroenhancement,” offering a novel definition as well as spelling out three conditions under which we expect that such neuroenhancement would be most likely to be permissible (or even desirable). Furthermore, we draw a distinction between first-order moral capacities, which we suggest are less promising targets for neurointervention, and second-order moral capacities, which we suggest are more promising. We conclude by discussing concerns that moral neuroenhancement might restrict freedom or otherwise “misfire,” and (...) argue that these concerns are not as damning as they may seem at first. (shrink)

Scientific progress in recent neurofeedback research may bring about a new type of moral neuroenhancement, namely, neurofeedback-based moral enhancement; however, this has yet to be examined thoroughly. This paper presents an ethical analysis of the possibility of neurofeedback-based moral enhancement and demonstrates that this type of moral enhancement sheds new light on the moral enhancement debate. First, I survey this debate and extract the typical structural flow of its arguments. Second, by applying structure to the case of neurofeedback-based moral enhancement, (...) I examine the ethical, legal, and social issues to show that this technique is unique and traditionalist, which makes it compatible with almost all our conservative notions, so that it, accordingly, can be seen as an ethically acceptable option. Third, by rejecting the premise in the moral enhancement debate that bio/neuro-enhancement has its unique ELSI that traditional methods would never create, I demonstrate that, by virtue of its traditional or conservative features, neurofeedback-based moral enhancement can be incorporated into the traditional moral education network. Finally, I conclude that, being a part of the traditional moral education network, neurofeedback-based moral enhancement can be a unique and ethically acceptable option of moral neuroenhancement. (shrink)

Non-invasive transcranial electrical brain stimulation (tES) techniques, including transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS), can alter neuronal activity and related brain functions. However, tES effects seem to be modulated by various influencing factors, leading to high inter-individual variability in tES effects and often only low effect sizes, or even no effects. The present thesis therefore aimed to investigate methodological and physiological influencing factors of tDCS, tACS and tRNS that have not (...) been sufficiently examined so far. A first study investigated the influence of montage and individual functional performance level on the effects of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) in healthy adults. Compared with sham stimulation, a multichannel montage led to stronger effects than a bipolar montage. For both montages the effects of stimulation were dependent on the functional performance level of participants. A second study investigated the effects of multichannel tDCS over the left DLPFC in healthy children and adolescents, considering the influence of concurrent target task performance during stimulation and individual head anatomy. tDCS did not influence the target outcome but led to transfer effects on non-target task performance and neurophysiological activity, that were only partly influenced by task performance during stimulation. The individual head anatomy had no influence on stimulation effects. A third study investigated tACS and tRNS effects on motor cortex excitability in healthy children and adolescents in comparison to adults. The individual response to sham stimulation was investigated as marker for the individual physiological brain state. Motor cortex excitability was not modulated by age but by individual response to sham stimulation. All studies provide important insights into the modulatory factors of stimulation effects. Based on these results, future studies should aim at individualising tES application. (shrink)