Ethical Issues Surrounding Neuroscience

In world war II, the Nazi regime performed a number of experiments on human prisoners. While these experiments were gruesome and deadly, in some cases they did allow some insight into the thresholds of the human body and the capabilities we have. However, despite whatever advances may have been made, the costs far outweighed any gains made in research. Although the term bioethics was coined in the early 20th century, the events of world war II and other human research such as in the Manhattan project, with the human study of the effects of radiation on human beings, helped to create and establish the field of bioethics. Although the events of world war II are thought to contribute to the establishment of bioethics, it would not become a national issue until much later.

It wasn't until the 1960s when Henry Beecher published in the New England Journal of Medicine about 22 unethical studies performed that some traction was given to the issue. Even then, it was slow to have an effect since experiments, such as the CIA mind control experiment, were kept secret, and fears of war with the Soviet Union dominated the media. Even after this publication, it was not until 1974 that congress passed the National Research Act. Since then, the field has grown tremendously and expanded to tackle issues around relevant topics. Today, there is very little research that does not have some component of ethical review before approval. But as science makes advances in research, it brings up more complex ethical questions and dilemmas, and the field of neuroscience is no exception.

For this reason, it is important that we have people like Professor Joseph Vukov to help us think about these questions that are raised as our capabilities expand. I had the pleasure of hearing him speak on two separate occasions about complex moral and ethical problems surrounding neuroscience research and the medical technological advances accompanying it. In his presentation to the neuroscience seminar at Loyola, he discussed issues of modern neuroethics specifically as it relates to memory modification, and his developing theory of treatmentalism. Experimentally, it seems that the drug propanolol can block memory consolidation, such as with classical conditioning when mice remember a painful experience paired with a certain environment or context, but also in humans suffering from PTSD. This drug has opened the possibility that the context and nature of memories can be altered experimentally, and has caused moral and ethical debate.

In his presentation, he goes on to express two opposing views. One viewpoint is form those whom he calls the alarmists. The alarmists warn that any change to memory integration or context could have drastic repercussions that could alter the human experience and alter the fundamental personality of the individual that makes them who they are. Alternatively, the opposing side is a group he calls the modifiers. Modifiers are those who believe memory alteration should be permissible as long as it does not do harm. These opposing views both have great promise and great risk and compete against one another.

Dr. Vukov suggested reconciling the views by only using memory modification on a limited scale. He is working to develop his theory of treatmentalism, in which memory modification is used as treatment and only to the point where its restorative powers return an individual to his or her normal level of functioning. This raises questions in itself of what is defined as a normal level of functioning among many other things.

In my opinion, while fascinating, Dr. Yukov's theory has many shortcomings. It fails to address the concerns of the effect alteration will have on the individual. While some effects may be used as treatment, it is still obscure as to what the side effects would be. It would also need to be defined as what cases can be treated and what is defined as normative level of functioning. Also, should it be used in developing humans such as kids whose personalities are extremely malleable? The different ways of assessing the risk are seemingly infinite. However, the capability to alter memory seems to be a direction that research may be heading and that is why it is important to start asking these challenging questions now, but it may be too late.

In modern medicine, it is now possible for a patient to receive a head transplant. This has raised a host of question as to the identity of the person post-procedure. While the head may be of one body, it must interact with the new body and nervous system. Thus, these ethicists propose that the resulting personality is new and distinct from both older forms from the donor and recipient. By altering the body in which the brain is integrated with, they have arguably altered the identity of the individual. The same is plausible to take place in selectively altering the effects of memory on a personality. More broadly, there is the question of who, how, and when memory altering drugs can be used. My last concern is that the people making these decisions may be influenced by their personal or even social definitions of what normal or normative functioning is and it may conflict with social ideologies that praise individuality and self determination despite faults.

Ultimately, the use of neuroethics is becoming increasingly relevant and necessary. It faces many challenging questions in the future. Nonetheless, as we progress, I think strict observation will be needed. As much as institutional review boards can hinder the progress of research, they are an essential part of the process, and perhaps more emphasis with neuroethical input is needed for future experimental review processes as well as further public debate and discussion. 

Sources:

http://www.niehs.nih.gov/research/resources/bioethics/timeline/

Pascalev, A., Pascalev, M., & Giordano, J. (2016). Head transplants, personal identity and neuroethics. Neuroethics, 9(1), 15-22.

Rinčić, I., Muzur, A.: Fritz Jahr i rađanje europske bioetike (Fritz Jahr and the Birth of European Bioethics). Zagreb: Pergamena, 2012., page 141 (translated)