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 29, 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 7, 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 [1] propose. (Source: Neuroethics)
Source: Neuroethics - July 24, 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 empirical...
Source: Neuroethics - July 15, 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. Clinicians ...
Source: Neuroethics - July 11, 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 7, 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 can also access...
Source: Neuroethics - July 3, 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 responsible...
Source: Neuroethics - June 13, 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-computer ...
Source: Neuroethics - May 28, 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 discipline...
Source: Neuroethics - May 25, 2019 Category: Medical Ethics Source Type: research
Justice Without Retribution: Interdisciplinary Perspectives, Stakeholder Views and Practical Implications
(Source: Neuroethics)
Source: Neuroethics - May 20, 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”. First...
Source: Neuroethics - May 11, 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 forms of ...
Source: Neuroethics - May 6, 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 neuropsychiatric s...
Source: Neuroethics - April 30, 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 approach emphasizes the brain as the sea...
Source: Neuroethics - April 23, 2019 Category: Medical Ethics Source Type: research
