The Routledge Handbook of Neuroethics

L. Syd M Johnson, Karen S. Rommelfanger, L. Syd M Johnson, Karen S. Rommelfanger

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317483519
• Edition: 1
• Topic: Philosophy
• Subtopic: Philosophy History & Theory

The Routledge Handbook of Neuroethics offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. Written by 61 key scholars and fresh voices, the Handbook's easy-to-follow chapters appear here for the first time in print and represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the Handbook's utility by providing readers with a contextual map for different approaches to issues and a guide to further avenues of interest.

Chapter 11 of this book is freely available as a downloadable Open Access PDF under a Creative Commons Attribution-Non Commercial-No Derivatives 3.0 license. https://www.routledgehandbooks.com/doi/10.4324/9781315708652.ch11

Part I

What Is Neuroethics?

In a seminal 2002 paper, philosopher and neuroscientist Adina Roskies bisected the field of neuroethics into two broad sectors: the ethics of neuroscience and the neuroscience of ethics. The ethics of neuroscience overlaps significantly with traditional issues in biomedical ethics, including clinical ethics, the ethics of neuroscientific research, and the ethical, legal, and social implications of new developments and discoveries in neuroscience. Neuroethics is more than a subdiscipline of traditional biomedical ethics, however, particularly in its second sector, the so-called neuroscience of ethics, which examines traditional ethical questions through a neuroscientific lens. Metaphysical inquiries concerning free will, personal identity, and the nature of consciousness are also within the purview of neuroethics, as they inform and interact with important ethical and social issues. Neuroethics explores the neurological foundations of these age-old philosophical problems but also brings to bear techniques from the cognitive and social sciences to reexamine them in a new light.

This section provides background on the historical development of neuroethics and offers a frame for viewing the core categories of neuroethical inquiry. In the first chapter, “The Competing Identities of Neuroethics: Remarks on Theoretical and Methodological Assumptions and Their Practical Implications for the Future of Neuroethics,” Racine and Sample explore the ongoing debates about the identity and assumptions of neuroethics. In the second chapter, “Neuroethics and the Neuroscientific Turn,” Hildt and Leefmann challenge us to engage in deeper transdisciplinary inquiry—to more closely examine the methodologies that neuroethics seeks to address and utilize. These chapters address arguments about the inter- or transdisciplinary nature of neuroethics, as well as the unique integration and entanglement of the questions neuroethics and neuroethicists engage with, along with an overview of neuroethics scholarship and methodologies.

1

The Competing Identities of Neuroethics

Remarks on Theoretical and Methodological Assumptions and Their Practical Implications for the Future of Neuroethics

Eric Racine and Matthew Sample

Neuroethics has evolved significantly in the last 15 years (Marcus, 2002). From rather amorphous ideas, the field of neuroethics has taken shape in different ways. Academic programs dedicated to neuroethics have flourished in several countries, monographs and edited volumes have been published, specialized journals have endured and grown to be impactful (e.g., Neuroethics, American Journal of Bioethics—Neuroscience), national and international societies and networks dedicated to neuroethics have emerged, and, perhaps more importantly, young researchers have been trained in neuroethics, while more established researchers have developed robust research programs funded through both strategic and open funding competitions. All these developments testify to the field’s successes and development. As one of the authors can attest, graduate training in the late 1990s on neuroethics topics and engagement of colleagues about them was a marginal and often misunderstood endeavor. The idea of a two-way dialogue between neuroscience and ethics appeared as a radical idea. The practical ethical issues associated with clinical neurosciences were truly neglected, even 25 years after Pontius’s landmark paper (Pontius, 1973), perhaps because of intellectual and organizational focus on ethical issues in genetics and genomics at the time (Evans, 2000, 2002).

Despite the great leaps forward, there are a number of meta-questions about the field of neuroethics, that is, epistemological issues that underlie the development of the field of neuroethics that are worth articulating explicitly. Attending to these questions could help scholars examine some of the underlying commitments of neuroethics scholarship as well as some of the significant diversity and pluralism encountered within the field. In this chapter, we explore a number of such questions, hopefully to provide an additional lens to approach the other contributions in this volume. As we do so, we stress the existence of healthy pluralism with respect to the issues identified and indicate the implications of some of the available answers while inviting readers to make up their own minds about the appropriateness of the solutions provided so far. We structure our remarks to reflect on “where are we looking from?” “what are we looking at?” and “for which goals?” and highlight how different meta-approaches generate responses to these questions.

“Where We Are Looking From”: Brain, Mind, and the Scientific and Manifest Images

One of the most profound sources of pluralism in neuroethics concerns the initial stance from which neuroethics is approached. We notice two primary standpoints from which investigators begin their inquiry, one scientific and one humanistic. Thus for any given neuroethics topic, we can ask: are these questions triggered by the fact that the brain is involved, or is it rather their profound effects on the mind, that is, the cognitive, affective, and social dimensions of human life? Clearly, the former view, “the view from the brain” (or scientific image), has received the most explicit support within the field of neuroethics. Starting with Safire, who is often wrongly credited for forging the term “neuroethics” (Pontius, 1973), the field has been described as “a distinct portion of bioethics, which is the consideration of good and bad consequences in medical practice and biological research” (Safire, 2002). Safire adds that “the specific ethics of brain science hits home as research on no other organ does” (Safire, 2002). Likewise, the cognitive neuroscientist Michael Gazzaniga summoned neuroethics a few years later to become firmly entrenched in the biological sciences. According to him, “neuroethics is more than just bioethics for the brain. (…) It is—or should be—an effort to come up with a brain-based philosophy of life” (Gazzaniga, 2005). These views clearly emphasize, to paraphrase Sellars (Sellars, 1963), how the emerging (neuro)“scientific image” of humankind will shape the “manifest image” of humankind; cherished or entrenched understandings of the self, of humanity, and of normativity are to be reframed in terms of neural activity, of technological interventions, and revealed tissue structure.

At the same time, there is no clear reason to restrict neuroethical discussion to the impact of sciences and technologies of the brain, narrowly construed. Many non–neuroscience-based technologies induce comparable effects on the self and moral agency. And interest in interventions on the brain (e.g., deep brain stimulation, functional neuroimaging, neuropharmacology) is largely contingent on their impact on the mind. These observations suggest that our focal point need not be the brain at all and that a “view from the mind” could offer a distinct starting point. Beginning from the mind rather than just its physical or material aspects makes the significance of the “lived brain” (the mind) explicit and primary. Accordingly, scholarship in this mode features a persistent engagement with the humanities or social sciences—as supplements to neuroscience—or careful attention to embodied experience. This stance may entail, for instance, interviewing persons with ALS about the role of neural technology in their life (Blain-Moraes et al., 2012), analyzing media representations of neuroscience (Racine et al., 2010), or attending closely to everyday situations or clinical contexts (Fins, 2017). Each provides crucial resources for studying the mind as a biopsychosocial or experiential phenomenon. In sum, the “view from the mind” does not deny the importance of the “neuro,” but it places it alongside a more comprehensive range of knowledge and tools that affect us humans and our self-understanding. From this perspective, the physical brain is special because of its (situated, shifting) meaning and not because of its intrinsic mechanisms or essential structure.

The field’s name, of course, does not unambiguously express each of these two views (i.e., from the brain, from the mind). Sometimes neuroethics seems to be committed to a form of reductionism or the epistemic supremacy of neurosciences such that some priority is given to disciplines that study the brain as both a source of knowledge on morality and a source of ethical questions to address (Whitehouse, 2012; Racine and Zimmerman, 2012). Vidal and Piperberg (2017) claim that “Neuroethics (…) presupposes that the neural aspects of human nature are most directly relevant to many of the questions raised in the Western philosophical and ethical traditions, including issues of personhood and personal identity” (Vidal and Piperberg, 2017). In our view, such reductionism is not inherent to neuroethics. As we hint in the previous paragraph, there are scholars beginning from the mind and not just the brain. Nevertheless, the worries expressed here call for further thinking about the competing views on neuroethics. While both the “view from the brain” and “the view from the mind” can coexist, they represent an implicit (and sometimes explicit) dialectic, wherein researchers must decide which is more fundamental: organ or life world. Indeed, this tension between these stances, however articulated, has implications for theoretical, methodological, and practical orientations of contributors to the field. We will return to these concrete implications at the chapter’s end, but first we consider another key epistemological question, “What are we looking at?”

“What Are We Looking At?” Areas of Focus and Questions of Interest for Neuroethics

In 1973, the psychiatrist Anneliese Pontius first (to our knowledge) described neuroethics as a “new and neglected area of ethical concern” (Pontius, 1973). Pontius was particularly concerned with nonvalidated interventions in young children and the misuse of neuroscience research. Some years after, the neurologist Ronald Cranford boldly named a new type of specialist, the “neuroethicist,” a neurologist with expertise in bioethics often called upon to deal with questions such as brain death or end-of-life care in dementia (Cranford, 1989). Clearly, these pioneers held a view according to which neuroethics should be dedicated to examining ethical questions related to clinical practice in neurology and psychiatry. Others have followed suit, such as the neurologist James Bernat, author of Ethical Issues in Neurology (first edition in 1994; third edition published in 2008; Bernat, 2002) and the physician and bioethicist Joseph Fins. The latter has formulated several critiques against current neuroethics, stressing the need to reorient efforts to address important healthcare-related questions (Miller and Fins, 1999; Fins, 2000; Fins, 2005; Fins et al., 2006; Fins, 2008; Fins, 2017).

Others view neuroethics as a “content field” of bioethics which is defined by its focus on different neurotechnologies. Writing the entry on neuroethics in the Encyclopedia of Bioethics, Paul Wolpe states that

[n]euroethics involves the analysis of ethical challenges posed by chemical, organic, and electrochemical interventions in the brain (…) Neuroethics encompasses both research and clinical applications of neurotechnology as well as social and policy issues attendant to their use (…) Neuroethics is a content field, defined by the technologies it examines rather than any particular philosophical approach. The field’s distinctiveness derives from novel questions posed by applying advanced technology to the brain, the seat of personal identity and executive function in the human organism.

(Wolpe, 2004)

This view of neuroethics as a content field of bioethics dominated the first years of publication in neuroethics. A review found that the characterization of neuroethics as an “ethics of neuroscience” and as a “branch of bioethics” were respectively the first and fourth most common ways of describing neuroethics (Racine, 2010). More recent reviews have confirmed this focus on the ethics of neuroscience in recent literature (Leefmann et al., 2016). However, the view that neuroethics is defined by its focus on neurotechnologies has sparked profound debates, notably about the alignment or even the complicity of neuroethics with the agenda of neuroscience research and technology (Vidal, 2009; Vidal and Piperberg, 2017; De Vries, 2007; Parens and Johnston, 2006; Parens and Johnston, 2007).

Some have warned that, by tying its content to a particular set of neurotechnologies, neuroethics could get too close to science and industry, losing its critical spirit. Citing the case of genethics, Turner notes that ethics research agendas are often defined by trends in funding and broader institutional culture, such that more pressing societal problems fall by the wayside (Turner, 2003). We might diagnose this as a case of ethicists adopting the entrepreneurial culture of medicine and science, diluting and endangering their role as critical scholars (Turner, 2004a,b). But there is more to consider here than mere self-interest or fame-hungry academics. The drive to focus specifically on neuroscience content emerges from a more encompassing sociocultural ecosystem involving a range of actors, including popular media outlets distributing brain images, parents seeking neural perspectives on their children’s development, military research agencies, and of course the sociologists and ethicists that follow along (Pickersgill, 2013). As a result, a content-based definition of neuroethics may need to be understood as both an intellectual commitment made by its practitioners and as a dynamic definition within an “economy of technoscientific promises” (Joly, 2013). Indeed, newly defined areas of study rarely arise independently of their cultural moment.

Neuroethics as an ethics of neuroscience and neurotechnology described earlier, however, is not the only view of the field. Another view builds on the ethics of neuroscience but adds that neuroscience of ethics is a key area of focus of neuroethics (Roskies, 2002). Accordingly, neuroethics promises to create a two-way dialogue about the implications of neuroscience for views on ethics and morality. Roskies is rightfully credited for articulating this duality of neuroethics most clearly (Roskies, 2002), although such a view can be traced back to the origins of bioethics (Potter, 1970, 1971):

As we see it, there are two main divisions of neuroethics: the ethics of neuroscience and the neuroscience of ethics. The ethics of neuroscience can be roughly subdivided into two groups of issues: (1) the ethical issues and considerations that should be raised in the course of designing and executing neuroscientific studies (the ethics of practice) and (2) evaluation of the ethical and social impact that the results of those studies might have, or ought to have, on existing social, ethical, and legal structures (the ethical implications of neuroscience). The second major division I highlighted is the neuroscience of ethics. Traditional ethical theory was centered on philosophical notions such as free-will, self-control, personal identity, and intention. These notions can be investigated from the perspective of brain function (Roskies, 2002).

This view is often alluded to and supported (Levy, 2007; Glannon, 2007) but not unanimously agreed upon. Consistent with Wolpe’s definition, Wolpe and Farah (Farah and Wolpe, 2004) comment that the neuroscience of ethics introduces confusion about the nature of neuroethics. Others have faulted the neuroscience of ethics for introducing different forms of reductionism and essentialism that jeopardize the richness of the analysis it could offer. These critiques are well known to those who have followed the development of neurophilosophy (Churchland, 1986; Changeux, 1983) and its application to ethics (Changeux, 1996; Changeux and Ricoeur, 2000; Churchland, 1998, 2002).

Finally, some have proposed integrative accounts that build on the diversity of views on neuroethics. Racine (2010) relies on a pragmatist account of ethics to make the case for the contribution of neuroscience—alongside many other empirical disciplines—to the understanding of human morality while at the same time arguing strongly for the practical role of neuroethics in dealing with healthcare, health policy, and research ethics issues in the context of neuroscience. However, according to this view, the rationale for a neuroethics ma...

Table of contents

• Cover
• Title
• Copyright
• Dedication
• Contents
• List of Contributors
• Introduction
• Part I What Is Neuroethics?
• Part II The Ethics of Neuroscience
• Part III The Neuroscience of Ethics
• Part IV Expanding the Frame
• Index