Narrative Devices: Neurotechnologies, Information, and Self-Constitution
This article provides a conceptual and normative framework through which we may understand the potentially ethically significant roles that information generated by neurotechnologies about our brains and minds may play in our construction of our identities. Neuroethics debates currently focus disproportionately on the ways that third parties may (ab)use these kinds of information. These debates occlude interests we may have in whether and how we ourselves encounter information about our own brains and minds. This gap is not yet adequately addressed by most allusions in the literature to potential identity impacts. These la...
Source: Neuroethics - September 28, 2020 Category: Medical Ethics Source Type: research
The Fragility of Moral Traits to Technological Interventions
AbstractI will argue that deep moral enhancement is relatively prone to unexpected consequences. I first argue that even an apparently straightforward example of moral enhancement such as increasing human co-operation could plausibly lead to unexpected harmful effects. Secondly, I generalise the example and argue that technological intervention on individual moral traits will often lead to paradoxical effects on the group level. Thirdly, I contend that insofar as deep moral enhancement targets higher-order desires (desires to desire something), it is prone to be self-reinforcing and irreversible. Fourthly, I argue that the...
Source: Neuroethics - September 26, 2020 Category: Medical Ethics Source Type: research
Disorders of Consciousness: An Embedded Ethnographic Approach to Uncovering the Specific Influence of Functional Neurodiagnostics of Consciousness in Surrogate Decision Making
AbstractA recent qualitative study published in Neuroethics by Schembs and colleagues explores how functional neurodiagnostics of consciousness inform surrogate decision making in cases of disorders of consciousness. In this commentary, we argue that the chosen methodology significantly limits the scope of the potential conclusions and suggest an embedded ethnographic approach of co-presence as an alternative. (Source: Neuroethics)
Source: Neuroethics - September 17, 2020 Category: Medical Ethics Source Type: research
Neuro-Doping and Fairness
AbstractIn this article, we critically discuss different versions of the fairness objection to the legalisation of neuro-doping. According to this objection, legalising neuro-doping will result in some enjoying an unfair advantage over others. Basically, we assess four versions. These focus on: 1) the unequal opportunities of winning for athletes who use neuro-doping and for those who do not; 2) the unfair advantages specifically for wealthy athletes; 3) the unfairness of athletic advantages not derived from athletes ’ own training (conventionally understood); and 4) the unfair health care costs imposed on everyone a...
Source: Neuroethics - August 17, 2020 Category: Medical Ethics Source Type: research
Neuro-Doping – a Serious Threat to the Integrity of Sport?
AbstractThe formation of the World Anti-Doping Agency (WADA) in 1999 was spurred by the 1998 revelation of widespread use in professional cycling of erythropoietin (EPO). The drug was supposedly a real danger. The long-term consequences were unknown, but rumor said it made athletes ’ blood thick as jam with clots and other circulatory fatalities likely consequences. Today the fear of EPO has dampened. However, new scientific avenues such as ‘neuro-doping’ have replaced EPO as emergent and imagined threats to athletes and to the integrity of sport. In this paper, we analy ze the alleged threat from ‘...
Source: Neuroethics - July 29, 2020 Category: Medical Ethics Source Type: research
The Ethics of Motivational Neuro-Doping in Sport: Praiseworthiness and Prizeworthiness
AbstractMotivational enhancement in sport – a form of ‘neuro-doping’ – can help athletes attain greater achievements in sport. A key question is whether or not that athlete deserves that achievement. We distinguish three concepts – praiseworthiness (whether the athlete deserves praise), prizeworthiness (whether the athlete deserve s the prize), and admiration (pure admiration at the performance) – which are closely related. However, in sport, they can come apart. The most praiseworthy athlete may not be the most prizeworthy, and so on. Using a model of praiseworthiness as costly commitme...
Source: Neuroethics - July 23, 2020 Category: Medical Ethics Source Type: research
Neuro-Doping as a Means to Avert Fascistoid Ideology in Elite Sport
AbstractAssume that neuro-doping is safe and efficient. This means that the use of it, and similar future safe methods of enhancement in sport, may help those who are naturally weak to catch up with those who are naturally strong and sometimes even defeat them. The rationale behind anti-doping measures seem to presuppose that this is unfair. But the idea that those who are naturally strong should defeat those who are naturally weak rests on a fascistoid ideology that sport had better leave behind. Neuro-doping may be seen as a means to undermine the fascistoid notion of fairness. The conjecture is that, given that society ...
Source: Neuroethics - July 16, 2020 Category: Medical Ethics Source Type: research
Correction to: Pragmatismand the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS
The article Pragmatismand the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS (Source: Neuroethics)
Source: Neuroethics - July 6, 2020 Category: Medical Ethics Source Type: research
First Epileptic Seizure and Initial Diagnosis of Juvenile Myoclonus Epilepsy (JME) in a Transcranial Direct Current Stimulation (tDCS) Study – Ethical Analysis of a Clinical case
AbstractWe discuss an epileptic incident in an undiagnosed 13-year old girl participating in a clinical study investigating the effects of transcranial direct current stimulation (tDCS) in healthy children and adolescents. This incident poses important research ethics questions with regard to study design, especially pertaining to screening and gaining informed consent. Potential benefits and problems of the incident also need to be considered. The ethical analysis of the case presented in this paper has been informed by an in-depth interview conducted after the incident with the child and the accompanying parent. We discu...
Source: Neuroethics - July 1, 2020 Category: Medical Ethics Source Type: research
“Fueling up” Gamers. The Ethics of Marketing Energy Drinks to Gamers
AbstractIn this article, I investigate whether states should regulate energy-drink marketing practices targeting gamers. Energy drinks are high-sugar, high-caffeine, non-alcoholic beverages that allegedly improve energy, stamina, cognitive performance, and concentration. First, I define what “gamer” means and identify the market agents that play a crucial role in the gaming community, including the energy-drink industry. In doing so, I analyze energy-drink marketing practices and explore calls for regulating them. Second, I draw parallels between regulation of energy-drink marketing and marketing of products su...
Source: Neuroethics - July 1, 2020 Category: Medical Ethics Source Type: research
Determinism and Destigmatization: Mitigating Blame for Addiction
AbstractThe brain disease model of addiction is widely endorsed by agencies concerned with treating behavioral disorders and combatting the stigma often associated with addiction. However, both its accuracy and its effectiveness in reducing stigma have been challenged. A proposed alternative, the “choice” model, recognizes the residual rational behavior control capacities of addicted individuals and their ability to make choices, some of which may cause harm. Since harmful choices are ordinarily perceived as blameworthy, the choice model may inadvertently help justify stigma. This paper seeks to fully naturaliz...
Source: Neuroethics - June 27, 2020 Category: Medical Ethics Source Type: research
Born which Way? ADHD, Situational Self-Control, and Responsibility
AbstractDebates concerning whether Attention Deficit/Hyperactivity Disorder (ADHD) mitigates responsibility often involve recourse to its genetic and neurodevelopmental etiology. For such arguments, individuals with ADHD have diminished self-control, and hence do not fully satisfy the control condition for responsibility, when there is a genetic or neurodevelopmental etiology for this diminished capacity. In this article, I argue that the role of genetic and neurobiological explanations has been overstated in evaluations of responsibility. While ADHD has genetic and neurobiological causes, rather than embrace th...
Source: Neuroethics - June 25, 2020 Category: Medical Ethics Source Type: research
Forensic Brain-Reading and Mental Privacy in European Human Rights Law: Foundations and Challenges
AbstractA central question in the current neurolegal and neuroethical literature is how brain-reading technologies could contribute to criminal justice. Some of these technologies have already been deployed within different criminal justice systems in Europe, including Slovenia, Italy, England and Wales, and the Netherlands, typically to determine guilt, legal responsibility, or recidivism risk. In this regard, the question arises whether brain-reading could permissibly be used against the person's will. To provide adequate legal protection from such non-consensual brain-reading in the European legal context, ethicists hav...
Source: Neuroethics - June 20, 2020 Category: Medical Ethics Source Type: research
Deflating the Deep Brain Stimulation Causes Personality Changes Bubble: the Authors Reply
AbstractTo conclude that there is enough or not enough evidence demonstrating that deep brain stimulation (DBS) causes unintended postoperative personality changes is an epistemic problem that should be answered on the basis of established, replicable, and valid data. If prospective DBS recipients delay or refuse to be implanted because they are afraid of suffering from personality changes following DBS, and their fears are based on unsubstantiated claims made in the neuroethics literature, then researchers making these claims bear great responsibility for prospective recipients' medical decisions and subsequent well-being...
Source: Neuroethics - June 11, 2020 Category: Medical Ethics Source Type: research
Retributivism, Justification and Credence: The Epistemic Argument Revisited
AbstractHarming other people is prima facie wrong. Unless we can be very certain that doing so is justified under the circumstances, we ought not to do it. In this paper, I argue that we ought to dismantle harsh retributivist criminal justice systems for this reason; we cannot be sufficiently certain that the harm is justified. Gregg Caruso, Ben Vilhauer and others have previously argued for the same conclusion; however, my own version sidesteps certain controversial premises of theirs. Harsh retributivist criminal justice can only be morally right if the following three propositions are true: Moral responsibility exists, ...
Source: Neuroethics - May 29, 2020 Category: Medical Ethics Source Type: research
Neurostimulation, doping, and the spirit of sport
AbstractThere is increasing interest in using neuro-stimulation devices to achieve an ergogenic effect in elite athletes. Although the World Anti-Doping Authority (WADA) does not currently prohibit neuro-stimulation techniques, a number of researchers have called on WADA to consider its position on this issue. Focusing on trans-cranial direct current stimulation (tDCS) as a case study of an imminent so-called ‘neuro-doping’ intervention, we argue that the emerging evidence suggests that tDCS may meet WADA’s own criteria (pertaining to safety, performance-enhancing effect, and incompatibility with the &lsq...
Source: Neuroethics - May 16, 2020 Category: Medical Ethics Source Type: research
Respect, Punishment and Mandatory Neurointerventions
AbstractThe view that acting morally is ultimately a question of treating others with respect has had a profound influence on moral and legal philosophy. Not surprisingly, then, some scholars forcefully argue that the modes of punishment that the states mete out to offenders should not be disrespectful, and, furthermore, it has been argued that obliging offenders to receive neurological treatment is incompatible with showing them their due respect. In this paper, I examine three contemporary accounts of what showing respect for offenders in our sentencing practices would amount to: that it involves not interfering with off...
Source: Neuroethics - May 7, 2020 Category: Medical Ethics Source Type: research
Brain-Computer Interfaces and the Translation of Thought into Action
AbstractA brain-computer interface (BCI) designed to restore motor function detects neural activity related to intended movement and thereby enables a person to control an external device, for example, a robotic limb, or even their own body. It would seem legitimate, therefore, to describe a BCI as a system that translates thought into action. This paper argues that present BCI-mediated behavior fails to meet the conditions of intentional physical action as proposed by causal and non-causal theories of action. First, according to the causal theory of action physical actions are bodily movements that are causally related to...
Source: Neuroethics - May 4, 2020 Category: Medical Ethics Source Type: research
Autism Spectrum Condition, Good and Bad Motives of Offending, and Sentencing
This article aims to clarify how the difficulties affect the moral weight to be given to the good and bad motives of offending in sentencing offenders with ASC. I start by explicating the main points of departure of the endeavor. After that I assess the moral significance of the good a nd bad motives of offenders with ASC in view of four cases and a comparison with how we commonly treat people who are not as able to understand and react to the mental states of others as neurotypical adults. I suggest that considerations pertaining to what has been called the primary orientation of morality provide grounds for deeming the g...
Source: Neuroethics - April 28, 2020 Category: Medical Ethics Source Type: research
A Dilemma For Neurodiversity
AbstractOne way to determine whether a mental condition should be considered a disorder is to first give necessary and sufficient conditions for something tobe a disorder and then see if it meets these conditions. But this approach has been criticized for begging normative questions. Concerning autism (and other conditions), aneurodiversity movement has arisen with essentially two aims: (1) advocate for the rights and interests of individuals with autism, and (2) de-pathologize autism. We argue that denying autism ’s disorder status could undermine autism’s exculpatory role in cases where individuals with autis...
Source: Neuroethics - April 2, 2020 Category: Medical Ethics Source Type: research
Nonconscious Pain, Suffering, and Moral Status
AbstractPain is an unwanted mental state that is often considered a sufficient ground for moral status. However, current science and philosophy of mind suggest that pains, like other perceptual states, might be nonconscious. This raises the questions of whether the notion of nonconscious pain is coherent and what its moral significance might be. In this paper I argue that the existence of nonconscious pain is conceptually coherent; however as a matter of fact our brains might always represent pains consciously. I then characterize the concept of suffering from a naturalistic perspective, distinguishing it from pain. I offe...
Source: Neuroethics - February 5, 2020 Category: Medical Ethics Source Type: research
Delusion, Proper Function, and Justification
AbstractAmong psychiatric conditions, delusions have received significant attention in the philosophical literature. This is partly due to the fact that many delusions are bizarre, and their contents interesting in and of themselves. But the disproportionate attention is also due to the notion that by studying what happens when perception, cognition, and belief go wrong, we can better understand what happens when these go right. In this paper, I attend to delusions for the second reason —by evaluating the epistemology of delusions, we can better understand the epistemology of ordinary belief. More specifically, given...
Source: Neuroethics - January 30, 2020 Category: Medical Ethics Source Type: research
How Does Functional Neurodiagnostics Inform Surrogate Decision-Making for Patients with Disorders of Consciousness? A Qualitative Interview Study with Patients ’ Next of Kin
ConclusionWe hypothesize, that a group of next of kin of patients with DOC deals with functional neurodiagnostics results on the basis of the result ’s value and their high hope that the patient will recover meaningfully. A psychological mechanism seems to moderate the impact of functional neurodiagnostics on surrogate treatment decisions. (Source: Neuroethics)
Source: Neuroethics - January 11, 2020 Category: Medical Ethics Source Type: research
Responsibility, Determinism, and the Objective Stance: Using IAT to Evaluate Strawson ’s Account of our ‘Incompatibilist’ Intuitions
AbstractPeople who judge that a wrongdoer ’s behaviour is determined are disposed, in certain cases, to judge that the wrongdoer cannot be responsible for his behaviour. Some try to explain this phenomenon by arguing that people are intuitive incompatibilists about determinism and moral responsibility. However, Peter Strawson argues that we excuse determined wrongdoers because judging that someone is determined puts us into a psychological state – ‘the objective stance’ – which prevents us from holding them responsible, not because we think that determined wrongdoers cannot be responsible. Two...
Source: Neuroethics - January 4, 2020 Category: Medical Ethics Source Type: research
How Will Families React to Evidence of Covert Consciousness in Brain-Injured Patients?
AbstractThis commentary critically examines a recent qualitative study, published in this issue of Neuroethics, on the attitudes of family caregivers toward evidence of covert consciousness in brain-injured patients. (Source: Neuroethics)
Source: Neuroethics - January 4, 2020 Category: Medical Ethics Source Type: research
Neuroenhancement, the Criminal Justice System, and the Problem of Alienation
AbstractIt has been suggested that neuroenhancements could be used to improve the abilities of criminal justice authorities. Judges could be made more able to make adequately informed and unbiased decisions, for example. Yet, while such a prospect appears appealing, the views of neuroenhanced criminal justice authorities could also be alien to the unenhanced public. This could compromise the legitimacy and functioning of the criminal justice system. In this article, I assess possible solutions to this problem. I maintain that none of them qualifies as a satisfactory general solution to it, a solution that could reasonably ...
Source: Neuroethics - December 23, 2019 Category: Medical Ethics Source Type: research
The (in)Significance of the Addiction Debate
This article contends the belief that the two models in the addiction debate are polar opposites. It shows that it is not the large amount of addiction research in itself what sets the models apart, but rather their extrapolated conclusions. Moreover, some of the most fiercely debated aspects - for instance, whether or not addiction should be classified as a disease or disorder - are irrelevant for the conceptualisation of addiction. Instead, the real disagreement is shown to revolve around capacities. Discussing addiction-related capacities, especially regarding impaired control, rather than the assumed juxtaposition of t...
Source: Neuroethics - December 12, 2019 Category: Medical Ethics Source Type: research
An Instrument to Capture the Phenomenology of Implantable Brain Device Use
AbstractOne important concern regarding implantable Brain Computer Interfaces (BCI) is the fear that the intervention will negatively change a patient ’s sense of identity or agency. In particular, there is concern that the user will be psychologically worse-off following treatment despite postoperative functional improvements. Clinical observations from similar implantable brain technologies, such as deep brain stimulation (DBS), show a small b ut significant proportion of patients report feelings of strangeness or difficulty adjusting to a new concept of themselves characterized by a maladaptiveje ne sais quoi desp...
Source: Neuroethics - November 8, 2019 Category: Medical Ethics Source Type: research
AI Assistants and the Paradox of Internal Automaticity
In conclusion, we make practical recommendations for how to better manage the integration of AI assistants into society. (Source: Neuroethics)
Source: Neuroethics - November 1, 2019 Category: Medical Ethics Source Type: research
The Limited Relevance of Neuroimaging in Insanity Evaluations
AbstractForensic evaluations of insanity have recently borne witness to an influx of neuroimaging methods, especially structural and functional magnetic resonance imaging and positron emission tomography, to assist in the development of explanations that help to excuse legal responsibility for criminal behavior. The results of these scanning methods have been increasingly introduced in legal settings to offer or support a clinical diagnosis that in turn suggests that an individual was incapable of knowing right from wrong, or to pinpoint brain dysfunction suggestive of an inability to control behavior. This paper examines ...
Source: Neuroethics - October 30, 2019 Category: Medical Ethics Source Type: research
The Locked-in Syndrome: Perspectives from Ethics, History, and Phenomenology
AbstractThe existential situation of persons who suffer from the locked-in syndrome (LIS) raises manifold issues significant to medical anthropology, phenomenology, biomedical ethics, and neuroethics that have not yet been systematically explored. The present special issue ofNeuroethics illustrates the joint effort of a consolidating network of scholars from various disciplines in Europe, North America and Japan to go in that direction, and to explore LIS beyond clinical studies and quality of life assessments. (Source: Neuroethics)
Source: Neuroethics - August 8, 2019 Category: Medical Ethics Source Type: research
DBS and Autonomy: Clarifying the Role of Theoretical Neuroethics
AbstractIn this article, we sketch how theoretical neuroethics can clarify the concept of autonomy. We hope that this can both serve as a model for the conceptual clarification of other components of PIAAAS (personality, identity, agency, authenticity, autonomy, and self) and contribute to the development of the empirical measures that Gilbert and colleagues  propose. (Source: Neuroethics)
Source: Neuroethics - July 25, 2019 Category: Medical Ethics Source Type: research
Pragmatism and the Importance of Interdisciplinary Teams in Investigating Personality Changes Following DBS
AbstractGilbert and colleagues (2018) point out the discrepancy between the limited empirical data illustrating changes in personality (and related concepts of identity, agency, authenticity, autonomy, and self, i.e., PIAAAS) following implantation of deep brain stimulating (DBS) electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow ’s essay on the divide between the two cultures of the humanities (representing the conceptual publications) and the sciences (representing the empir...
Source: Neuroethics - July 16, 2019 Category: Medical Ethics Source Type: research
Changes in Personality Associated with Deep Brain Stimulation: a Qualitative Evaluation of Clinician Perspectives
This study contributes to the first-hand primary research on the topic exploring DBS clinicians ’ views on post-DBS personality change among their patients and its underlying cause. Semi-structured interviews were conducted with sixteen clinicians from various disciplines working in Australian DBS practice for movement disorders and/or psychiatric conditions. Thematic analysis of the intervi ews revealed five primary themes: 1) types, frequency and duration of personality change, 2) causes of personality change, 3) impact on patient and family, 4) communication, comprehension and awareness, and 5) management. Clinici...
Source: Neuroethics - July 12, 2019 Category: Medical Ethics Source Type: research
Committing Crimes with BCIs: How Brain-Computer Interface Users can Satisfy Actus Reus and be Criminally Responsible
AbstractBrain-computer interfaces allow agents to control computers without moving their bodies. The agents imagine certain things and the brain-computer interfaces read the concomitant neural activity and operate the computer accordingly. But the use of brain-computer interfaces is problematic for criminal law, which requires that someone can only be found criminally responsible if they have satisfied theactus reus requirement: that the agent has performed some (suitably specified) conduct. Agents who affect the world using brain-computer interfaces do not obviously perform any conduct, so when they commit crimes using br...
Source: Neuroethics - July 8, 2019 Category: Medical Ethics Source Type: research
Impact of the Japanese Disability Homecare System on ALS Patients ’ Decision to Receive Tracheostomy with Invasive Ventilation
This study aims to fill this gap by collecting and analyzing patients’ and family members’ narratives. In Japan, about 30% of ALS patients utilize TIV. This rate is much higher than in most other developed countries. Patients’ narratives illuminate the psychological and especially the c ontextual factors of their decision-making. Many Japanese patients who currently use a ventilator say that their family members encouraged them to prolong their lives through ventilation. These family members have done so because patients are able to use long-term ventilation for only ¥1000 (around $11) per month, and ...
Source: Neuroethics - July 4, 2019 Category: Medical Ethics Source Type: research
Brain Interventions, Moral Responsibility, and Control over One ’s Mental Life
AbstractIn the theoretical literature on moral responsibility, one sometimes comes across cases of manipulated agents. In cases of this type, the agent is a victim of wholesale manipulation, involving the implantation of various pro-attitudes (desires, values, etc.) along with the deletion of competing pro-attitudes. As a result of this manipulation, the agent ends up performing some action unlike any that she would have performed were it not for the manipulation. These sorts of cases are sometimes thought to motivate historical views of responsibility, on which the agent ’s past is relevant to whether she is respons...
Source: Neuroethics - June 14, 2019 Category: Medical Ethics Source Type: research
The history of BCI: From a vision for the future to real support for personhood in people with locked-in syndrome
AbstractThe history of brain-computer interfaces (BCI) developed from a mere idea in the days of early digital technology to today ’s highly sophisticated approaches for signal detection, recording, and analysis. In the 1960s, electroencephalography (EEG) was tied to the laboratory due to equipment and recording requirements. Today, amplifiers exist that are built in the electrode cap and are so resistant to movement artefact s that data collection in the field is no longer a critical issue. Within 60 years, the field has moved from simple and artefact-sensitive EEG recording to making real the vision of brain-c...
Source: Neuroethics - May 29, 2019 Category: Medical Ethics Source Type: research
On the Significance of the Identity Debate in DBS and the Need of an Inclusive Research Agenda. A Reply to Gilbert, Viana and Ineichen
AbstractGilbert et al. (Neuroethics,2018) argue that the concerns about the influence of Deep Brain Stimulation (DBS) on – as they lump together – personality, identity, agency, autonomy, authenticity and the self (PIAAAS) are due to an ethics hype. They argue that there is only a small empirical base for an extended ethics debate. We will critically examine their claims and argue that Gilbert and colleagues do no t show that the identity debate in DBS is a bubble, they in fact give very little evidence for that. Rather they show the challenges of doing research in a field that is stretched out over multiple di...
Source: Neuroethics - May 26, 2019 Category: Medical Ethics Source Type: research
Justice Without Retribution: Interdisciplinary Perspectives, Stakeholder Views and Practical Implications
Source: Neuroethics - May 21, 2019 Category: Medical Ethics Source Type: research
Discussions of DBS in Neuroethics: Can We Deflate the Bubble Without Deflating Ethics?
AbstractGilbert and colleagues are to be commended for drawing our attention to the need for a sounder empirical basis, and for more careful reasoning, in the context of the neuroethics debate on Deep Brain Stimulation (DBS) and its potential impact on the dimensions of personality, identity, agency, authenticity, autonomy and self (PIAAAS). While acknowledging this, this extended commentary critically examines their claim that the real-world relevance of the conclusions drawn in the neuroethics literature is threatened by the fact that the concepts at the center of the discussion have “weak empirical grounding&rdquo...
Source: Neuroethics - May 12, 2019 Category: Medical Ethics Source Type: research
Regulating the Use of Cognitive Enhancement: an Analytic Framework
AbstractRecent developments in neuroscience have enabled technological advances to modulate cognitive functions of the brain. Despite ethical concerns about cognitive enhancement, both individuals and society as a whole can benefit greatly from these technologies, depending on how we regulate their use. To date, regulatory analyses of neuromodulation technologies have focused on a technology itself – for instance, the U.S. Food and Drug Administration regulation of a brain stimulation device – rather than the use of a technology, such as the use of a brain stimulation device at work or school. Given that some f...
Source: Neuroethics - May 7, 2019 Category: Medical Ethics Source Type: research
‘Woe Betides Anybody Who Tries to Turn me Down.’ A Qualitative Analysis of Neuropsychiatric Symptoms Following Subthalamic Deep Brain Stimulation for Parkinson’s Disease
AbstractDeep brain stimulation (DBS) of the subthalamic nucleus (STN) for the treatment of Parkinson ’s disease (PD) can lead to the development of neuropsychiatric symptoms. These can include harmful changes in mood and behaviour that alienate family members and raise ethical questions about personal responsibility for actions committed under stimulation-dependent mental states. Qualitative inte rviews were conducted with twenty participants (ten PD patient-caregiver dyads) following subthalamic DBS at a movement disorders centre, in order to explore the meaning and significance of stimulation-related neuropsychiatr...
Source: Neuroethics - May 1, 2019 Category: Medical Ethics Source Type: research
Neuroessentialism, our Technological Future, and DBS Bubbles
AbstractHaving reviewed a considerable body of scholarly work in neuroethics related to DBS, Gilbert, Via ña, and Ineichen identify a major flaw in the debate—a “bubble” in the literature—and propose new directions for research. This comment addresses the authors’ diagnosis: What exactly is the nature of this bubble? Here, I argue that there are at least two different orientations in the “D BS causes personality changes” bubble. According to a first narrative, DBS is a special technology because its direct, causal action on the brain leads to personality changes. This approa...
Source: Neuroethics - April 24, 2019 Category: Medical Ethics Source Type: research
Why Neurotechnologies? About the Purposes, Opportunities and Limitations of Neurotechnologies in Clinical Applications
This article will shortly review different stakeholders ’ opinions and their expectation in the field, assembles information the state-of-the art in medical applications of neurotechnological implants and describes and assesses the fundamental technologies that are used to build up these implants starting with essential requirements of technical materi als in contact with living tissue. The different paragraphs guide the reader through the main aspects of neurotechnologies and lay a foundation of knowledge to be able to contribute to the discussion in which cases implants will be beneficial and in which cases we shou...
Source: Neuroethics - April 13, 2019 Category: Medical Ethics Source Type: research
More than our Body: Minimal and Enactive Selfhood in Global Paralysis
AbstractThis paper looks to phenomenology and enactive cognition in order to shed light on the self and sense of self of patients with locked-in syndrome. It critically discusses the concept of the minimal self, both in its phenomenological and ontological dimension. Ontologically speaking, the self is considered to be equal to a person ’s sensorimotor embodiment. This bodily self also grounds the minimal sense of self as being a distinct experiential subject. The view from the minimal bodily self presupposes that sociality comes after the self, or that in other words, the essence of self remains independent of our s...
Source: Neuroethics - April 10, 2019 Category: Medical Ethics Source Type: research
Locked-In Syndrome: a Challenge to Standard Accounts of Selfhood and Personhood?
AbstractA point made repeatedly over the last few years is that the Locked-in Syndrome (LIS) offers unique real-life material for revisiting and challenging certain ingrained philosophical assumptions about the nature of personhood and personal identity. Indeed, the claim has been made that a closer study of LIS will call into question some of the traditional conceptions of personhood that primarily highlight the significance of consciousness, self-consciousness and autonomy and suggest the need for a more interpersonal account of the person. I am skeptical about these claims and will in the following argue that the theore...
Source: Neuroethics - April 10, 2019 Category: Medical Ethics Source Type: research
Determinism, Moral Responsibility and Retribution
AbstractIn this article, we will identify two issues that deserve greater attention from those researching lay people ’s attitudes to moral responsibility and determinism. The first issue concerns whether people interpret the term “moral responsibility” in a retributive way and whether they are motivated to hold offenders responsible for pre-determined behaviour by considerations other than retributivism, e.g . the desires to condemn the action (as opposed to the actor) and to protect society. The second issue concerns whether explicitly rejecting moral responsibility and retributivism, after reading abou...
Source: Neuroethics - March 29, 2019 Category: Medical Ethics Source Type: research
A critical analysis of Australia ’s ban on the sale of electronic nicotine delivery systems
AbstractAustralia does not allow adult smokers to buy or use electronic nicotine delivery systems (ENDS) that contain nicotine without a prescription. This paper critically evaluates the empirical and ethical justifications provided for the policy by Federal and State governments, public health advocates and health organisations. These are: (1) that ENDS should only be approved as products for smoking cessation when there is evidence from randomised controlled trials that they are effective; (2) that as a matter of precaution we should not allow the sale of ENDS to smokers as consumer products because we do not know what t...
Source: Neuroethics - March 18, 2019 Category: Medical Ethics Source Type: research
What we (Should) Talk about when we Talk about Deep Brain Stimulation and Personal Identity
AbstractA number of reports have suggested that patients who undergo deep brain stimulation (DBS) may experience changes to their personality or sense of self. These reports have attracted great philosophical interest. This paper surveys the philosophical literature on personal identity and DBS and draws on an emerging empirical literature on the experiences of patients who have undergone this therapy to argue that the existing philosophical discussion of DBS and personal identity frames the problem too narrowly. Much of the discussion by neuroethicists centers on the nature of the threat posed by DBS, asking whether it is...
Source: Neuroethics - March 11, 2019 Category: Medical Ethics Source Type: research