Neuroethics: Navigating Issues of Neuroscience from Bench to Bedside James Giordano, PhD Neuroethics Studies Program Edmund D. Pellegrino Center for Clinical.

Neuroethics: Navigating Issues of Neuroscience from Bench to Bedside

James Giordano, PhDNeuroethics Studies Program

Edmund D. Pellegrino Center for Clinical Bioethicsand

Department of NeurologyGeorgetown University Medical Center

Washington, DC, USA

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The Three Pound Enigma

Tools, Theory, Progress

“Tools to theory” and “Theory to tools” heuristicsBasis for both Neuroscience and Neurotechnology

• Capabilities to Access, Assess and Manipulate Neural Function– Define, Evaluate, Treat, Prevent Pathology– Alter Sensation, Cognition, Emotion, Behavior

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Neuroscience and Neurotechnology

Translational applications in: Neurology and Neurosurgery Psychiatry Anesthesiology Pain Medicine Physical Medicine and Rehab Rheumatology Endocrinology Emergency Medicine Public Health... Law...

Daily Life... Military....

April 2, 2013: Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative

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The “Hard Problems”

Addressing the “hard problems” of neuroscience:– What is consciousness?– What is the mind?– What is/ is there a “self”?– Use of neurocentric criteria (for consciousness, “self”,

life, death)

Give rise to moral, ethical, legal and social issues, questions and problems…

The Challenge of Neuroethics

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Neuroethics

• Neuroethics: 2 “Traditions” 1. “The ethics of neuroscience”The ethical issues, questions and problems that arise in and from neuroscientific research and its applications (in medicine, public use, national security, etc.)

2.“The neuroscience of ethics” (sic.)Or the study of the neural basis of human ecology, morality and ethics (“neuro-ecology as neuromorality”)

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Reciprocity of Traditions“Two traditions”:Self-contained, self-referential modelBoth (a) lens and (b) mirror

Tasks: a) Examining if, how and why neuroscience can and/or

should be employed in various endeavors and circumstances

b) The neural bases of our social ecology & morality

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Neuroimaging

– PET– CT– MR– fMR– DTI– MEG/qEEG

Can we Scan the Brain to Depict Consciousness and/or “Read” Minds?

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Neurogenetics

– Genotyping– Phenotyping– Proteomics– Genetic Intervention(s)

Can we “Predict” or “Create” Present and Future “Selves”?

New Drugs

• Pain• Cognition• Emotion• Morality

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Interventional Neurotechnologies

– Indwelling devices• Brain implants• Micropumps

– Transcranial magnetic and electrical

stimulation– Tissue transplants– Genografts– Brain-machine

interfacing• Neurofeedback

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Neuroethico-Social Issues

• Uncertainties of Frontier Science– Runaway effects, Wexelblatt effects

• Treatment-Enablement-Enhancement Issues– What should be treated; enabled, enhanced?– In whom? – Are there/what are the limits?

• Existential Gain vs Loss– Implications of changing the human predicament

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Neuroethical, Legal and Social Issues (NELSI)

• Justice– “Who gets the “goodies?”

• The Question of “Culture”– What “good”? Whose rationale?

• Informed Consent– How informed?

• Neuro-ontologies– Neural norming; “Euneuromics”

• Legal Value/Validity – Neurocentric international standards?

Janusian Visage

Utopian Aspirations Dystopian Anxieties

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Neuroscience, Neurotechnology and Neuroethics

With increasing knowledge comes great power…

…With great power comes great responsibility

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The Ongoing Work of Neuroethics…

Reflection, insight and moral engagement must be the stepping stone for all future acts of

inquiry, invention and intervention…

“Measure twice, cut once”

…for all too often, there is no turning back.

Open-Access Bibliography of the Discipline

Further Reading• Stein DJ, Giordano J. Global mental health and neuroethics. BMC Medicine 13(1); (2015)

• Giordano J. The human prospect(s) of neuroscience and neurotechnology: Domains of influence and the necessity – and questions – of neuroethics. Human Prospect 4(1): 1-18 (2014).

• Shook JR, Giordano J. A principled, cosmopolitan neuroethics: Considerations for international relevance. Phil Ethics Humanities in Med 9 (1); (2014).

• Giordano J, Kulkarni A, Farwell J. Deliver us from evil? The temptation, realities and neuroethico-legal

issues of employing assessment neurotechnologies in public safety. Theoret Med Bioethics 15(3); (2014).

• Lanzilao E, Shook, J, Benedikter R, Giordano J. Advancing neuroscience on the 21st century world stage: The need for – and proposed structure of – an internationally relevant neuroethics. Ethics Biol Engineer Med 4(3): 211-229 (2013).

• Giordano J, Benedikter R. An early – and necessary – flight of the Owl of Minerva: Neuroscience, neurotechnology, human socio-cultural boundaries, and the importance of neuroethics. J Evolution and Technol 22(1): 14-25 (2012).

• Giordano J. Neuroethical issues in neurogenetics and neurotransplantation technology – the need for pragmatism and preparedness in practice and policy. Studies Ethics, Law Technol 5(1); (2011).

• Giordano J, DuRousseau D. Toward right and good use of brain-machine interfacing neurotechnologies: Ethical issues and implications for guidelines and policy. Cog Technol 15(2): 5-10 (2011).

ContactJames Giordano PhD

james.giordano@georgetown.edu

To learn more, see:www.neurobioethics.org