The 2014 International Neuroethics Society Annual Meeting

By Mallory Bowers




On November 14, the International Neuroethics Society convened for its annual meeting at the AAAS building in Washington, D.C. I had the pleasure of attending and presenting at INS through the generous support of the Emory Neuroethics Program. The society is an interdisciplinary group of scholars - including lawyers, clinicians, researchers, and policy makers - and the 2014 agenda reflected this diversity in expertise.




The conference opened with a short talk by Chaka Fattah, the U.S. representative for Pennsylvania’s 2nd congressional district. As a Philadelphia native, I was excited to learn that Congressman Fattah was an architect of the Fattah Neuroscience Initiative, which was an impetus for developing the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative.

Courtesy of Gillian Hue

Discussion of the BRAIN initiative continued through the following panels, “The BRAIN Initiative & the Human Brain Project: an Ethical Focus” and “The Future of Neuroscience Research & Ethical Implications”. Panelist Stephen Hauser spoke about the Presidential Commission for the Study of Bioethical Issues, while Henry Markram discussed the Human Brain Project – the European-based research collaboration to establish innovative neurotechnologies and develop a more thorough understanding of the human brain. Representatives of several scientific funding institutions (Dr. Tom Insel – Director of the National Institute of Mental Health, Dr. George Koob – Director of the National Institute on Alcohol Abuse and Alcoholism, and Dr. Geoff Ling – Defense Advanced Research Projects Agency) discussed the progress of neuroscience research, while emphasizing the need for continued advancement. Although the morning panels were interesting (as a behavioral neuroscientist, seeing Dr. Tom Insel was quite thrilling), I was left with the impression that the scientific “establishment” was only beginning to scratch the surface of the neuroethical implications of the research being conducted by scientists like myself. I wondered if any of the morning panelists attended the later sessions, which discussed more neuroethically hard-hitting issues, such as “Neuroscience in the Courts” and “Neuroscience and Human Rights”.



In the session “Neuroscience in the Courts – International Case Studies”, presenters considered how neuroscience has been used in the courtroom across the globe, specifically, the United States, the United Kingdom, Canada, the Netherlands, and Singapore and Malaysia. In particular, speakers examined the “my brain made me do it” defense used by adolescent defendants in criminal trials. This defense uses research on the developing prefrontal cortex of the adolescent, thought to be responsible for impulse control and executive function in mature adults (Blakemore and Robbins 2012), to explain criminal behavior. In the following session, “Neuroscience and Human Rights”, I was particularly struck by Dr. Mariana Chilton and her work on the neuroscience of food insecurity. While Dr. Chilton uses scientific research to demonstrate the deleterious effects of hunger on mental health, she advocates for an antidote that extends beyond science to include public policy.



The conference concluded with an hour long poster session after oral presentations by INS abstract awardees (our own Ryan Purcell presented on the ethical implications of the brain training program Lumosity). My poster, “Feminist neuroethics: biological determinism, agnotology, and overlooked risk factors for PTSD” examined potential alternative factors, besides “innate” neurobiology, that might explain the difference in prevalence of posttraumatic stress disorder (PTSD) among men and women (lifetime prevalence of PTSD is approximately 10-14% in women and 5-6% in men in the United States (Breslau, Davis, et al. 1991, Kessler, Sonnega, et al. 1995)). Sociocultural conditioning may be one possibility. Men and women are differentially conditioned according to expected gendered behaviors from birth. Epidemiological data demonstrates sex/gender differences in the prevalence of PTSD according to specific categories of trauma, but not others (Kessler, Sonnega, et al. 1995). This indicates that it is not merely the presence of trauma, but the interpretation of trauma that precipitates development of PTSD. If trauma severity - shaped by an individual’s unique perception/interpretation - influences risk for PTSD, and perception is gendered according to sociocultural conditioning, then researchers need to address whether specific forms of gendered sociocultural conditioning precipitate risk for PTSD. Furthermore, as diagnoses of psychiatric disorders (including PTSD) rely on clinician-defined suites of symptoms catalogued in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) rather than biomarkers, these diagnoses could be influenced by subjective and implicit gender stereotypes. Finally, the stress of microaggressions (Sue 2010) related to gender bias and discrimination could exert long-term ramifications, potentially contributing to rates of psychiatric disease like PTSD, as research demonstrates that pre-trauma risk factors like life stress predict PTSD (Yehuda 2004). I concluded my poster by advocating for an alliance between the sciences and humanities, who can provide a rich knowledge on how sociocultural factors shape conceptions of not only gender, but also illness.

Mallory presenting her poster (Courtesy of Gillian Hue)

Although scholars approaching neuroethics with a feminist lens seemed to be a small contingent at INS, reception to my poster was enthusiastic. Fellow feminist neuroethicist Vanessa Bentley had an especially exciting poster where she examined the evidence in favor of and against a sex/gender differences in size of the corpus callosum. Bentley’s analysis surmised lack of a sex/gender difference in the size of the corpus callosum. Bentley further argued that neurosexism perpetuated a conclusion to the contrary.



My hope is that the area of feminist neuroethics will continue to grow and be represented at forthcoming INS meetings and elsewhere, particularly in light of the recent NIH call to study both male and female experimental subjects. Historically, biomedical studies have not included female animal subjects to avoid the potential confounding variable of the estrous cycle. While a more balanced approach is a step in the right direction towards more comprehensive research, the field should be cautious in the design and interpretation of such studies, in order to avoid blind reinforcement of sex/gender-based biases – in particular, biased notions of how sex/gender may interact with behavior. Feminist empiricists’, bioethicists’, and neuroethicists’ critiques will be instrumental in helping the biomedical field move forward in an ethically and scientifically rigorous way, in light of the recent NIH mandate.



I would like to see feminist neuroscience studies impacting not just the laboratory but also the broader implications of the science as I describe with my work and the impact on clinical care. I would even see it relevant or as a key discussion under the theme of “neuroscience and human rights” at future INS meetings. If neuroscience is used as a tool to underline sex/gender differences in cognition, empathy, sexual behavior, parental investment, etc. – characteristics that have been used to disenfranchise women for centuries – then the work of the human rights field may invaluably inform future discourse. I look forward to participating in future INS events to continue to further my own neuroethical inquiries and to intersect with other sub-disciplines.






References




Blakemore, SJ and Robbins, TW (2012) Decision-making in the adolescent brain. Nat Neurosci 15: 1184-91.



Breslau, N, Davis, GC, Andreski, P and Peterson, E (1991) Traumatic events and posttraumatic stress disorder in an urban population of young adults. Arch Gen Psychiatry 48: 216-22.



Kessler, RC, Sonnega, A, Bromet, E, Hughes, M and Nelson, CB (1995) Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 52: 1048-60.



Yehuda, R (2004) Risk and resilience in posttraumatic stress disorder. J Clin Psychiatry 65 Suppl 1: 29-36.






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Bowers, M. (2014). The Neuroethics Blog. Retrieved on

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Media and social stigma can influence the patient adaptation to neurotechnologies and DBS

By Daniela Ovadia



Daniela Ovadia is the co-director of the Neuroscience and Society Lab
in the Brain and Behavioral Sciences Department of the University of Pavia and is the scientific director of Agenzia Zoe. 



Deep Brain Stimulation (DBS) is one of the oldest neuromodulation techniques; it was approved by the FDA in 1997 for the treatment of essential tremor, and a few years later, in 2002, the indication was extended to the treatment of Parkinson’s disease and dystonia (in 2003). In 2009 a new era for DBS started when the FDA also approved it as a therapy for obsessive-compulsive disorder. Some patients experienced a very good outcome, while others were less
lucky and experienced side effects such as cognitive, behavioral or
psychosocial impairments. DBS is now a common procedure for the
treatment of many motor and behavioral impairments.
As certain patients associations and civil liberties groups claimed that psychosurgery was back, and with it the social control on the patient’s mind, the media became interested in the topic. With the aim to protect the use of a promising technology, scientists and researchers also became involved in the field.



In this recently published article, authors Mecacci and Haselager focus their attention on the conceptual framework influencing the lack of compliance (or maladaptation, as they define it) to DBS implants. They identify two key elements determining patients expectations toward the effects of this neurodevice: mind-brain dualism (or, at the opposite, a braincentric point of view on human nature and behavior) and a hype in presenting potential benefits of new neurotechnologies. Both can modulate the patient’s expectations and influence the clinical and adverse effects of the device. But even if the authors cite the role of the media in shaping the public perception of new brain technologies and in building common knowledge about them, Mecacci and Haselager don’t delve deeply into the topic.




The scientific literature published on this issue offers an interesting point of view on the cultural determinants of biological responses to treatments. While reviewing 1,256 articles on different neurotechnologies published from 1994 to 2005 in the UK and USA lay press, Eric Racine noticed that 68% of the articles presented clinical or non-clinical benefits, while only 28% presented at least one scientific or ethical issue. Neurostimulation (as DBS) was depicted with a more variable tone of voice than other neurotechniques such as fMRI. The articles on DBS offered a broader point of view with many more “grey areas” often related to an implicit or explicit analogy with old psychosurgery techniques. The knowledge of the unfortunate outcomes of previous psychosurgical techniques, such as transorbital lobotomies, seems to be quite common among the lay public, and this appears to influence the media approach to DBS, at least when psychiatry use is discussed. More interestingly, many articles on DBS depict the brain under the framework of neuroessentialism and a combination of biological reductionism and enthusiasm for neuroscience research; the brain is the self-defining essence of a person, a sort of secular equivalent to the soul. Fixing the brain, we also fix the mood and the personality of the patient. Neuroessentialism can easily induce hype and excessive expectations regarding the effects of the brain implants, and can create a cognitive dissonance with the common instinctive adherence to dualism, as described by Mecacci and Haselager. Under these premises, maladaptation can be interpreted as disappointment in the results obtained after surgery, which are not as good and stable as imagined.




The neuroessentialist description of how the brain works evokes the idea of a machine that can easily be repaired, while the fluctuation in motor performances and mood after DBS implants can be perceived as a confirmation of the dualistic nature of the human being. The contrast between what was imagined and reality deeply influences the adaptation of patients to the device. This explanation fits perfectly with the so called hype cycle for new technologies, which starts with a peak of inflated expectations, followed by disillusionment, and ends in a plateau of adaptation to reality. Even if the hype cycle has been conceived to describe the creative process of researchers in science, it can be applied to patients dealing with new neurotechnologies where pros and cons are discovered on a daily basis.

From The Economist

There is a strong relationship between scientists’ perception of the opportunity offered by a new treatment and the expectations of the patient, and the hype is often generated by the scientists themselves. Many studies on the news cycle, from the scientific paper to the press release by scientific institutions to the final destination (the general media, passing through the desk of the journalists) demonstrate that the first source of the media are the scientists and the press releases. The media follow the “feelings” of their sources, which are not always balanced and neutral. Patients educate themselves and build their expectations in health issues from non specific sources, especially television, newspapers and internet. They are influenced by the media, who are the first source of their knowledge. In a previous work I considered the way the media reports on ethical issues related to DBS and the responsibility that journalists and scientists should feel toward the patients who have to decide if and when to undergo DBS. Very few articles discuss or mention the opportunity to use DBS in a vulnerable population such as Alzheimer’s patients (for memory enhancement) or psychiatric patients (such as in obsessive-compulsive disorders or Tourette syndrome). By supporting medical and scientific innovations without dealing with ethical issues, the media induce implicit ethical approval without an appropriate discussion both to society and to scientific community. This support also influences the selection of patient candidates for brain implantation.




The establishment of common criteria for patient selection in DBS is one of the main issues debated by the scientific community. In a review on ethical and social issues related to DBS by Bell and colleagues, the authors affirm this while analyzing the medical literature on this topic:

Important ethical and social challenges exist in the current and extending practice of DBS, notably in patient selection, informed consent, resource allocation, and in public understanding. These challenges are likely to be amplified if emerging uses of DBS in psychiatry are approved.

In a study on a sample of 36 patients who underwent DBS surgery for motor or psychiatric diseases, 2 patients reported unfavorable opinions on the outcome (5.5%) despite a significant improvement measured with proper clinical evaluation scales. The authors explain these negative judgments with an excess of expectations from the patients regarding the magnitude of the treatment effect. This result is consistent with previous studies on the outcomes of DBS that demonstrate that not only do a patient's expectations influence the satisfaction for the treatment, but the opinion of the caregivers do as well.




In patients affected by Tourette syndrome, the desire to avoid the social stigma related with the symptoms can also influence the effects of DBS. Servillo and colleagues report the case of a 36-year-old woman driven to continuous modifications of the stimulator settings by her mother who wasn’t satisfied with the results. She wanted her daughter completely freed from tourettic behavioral symptoms to avoid the social stigma, but not to relieve the symptoms.




The role of stigma in inducing the patient to choose a surgical treatment with DBS, especially in psychiatric conditions, has been highlighted also by Schlaepfer and Fins, who stressed the role of both media and doctors in shaping patient expectations.
More research is needed on the interaction between the cultural and conceptual framework of the patients towards new neurotechniques and the social determinants of this interaction. The hype cycle, nourished both by the media and scientists, is probably one of the most powerful. Ethicists should be aware of the way this cycle can determine the outcome of a treatment, but it can be modulated by a good procedure to obtain an informed consent.






References




Bell, E. et al. 2009. Preparing the ethical future of deep brain stimulation. Surgical Neurology 72: 577-586.



Clausen, J. 2010. Ethical brain stimulation – neuroethics of deep brain stimulation in research and clinical practice. European Journal of Neuroscience 32: 1152–1162.




Gilbert, F. and Ovadia, D. 2011. Deep brain stimulation in the media: over-optimistic portrayals call for a new strategy involving journalists and scientists in ethical debate. Frontiers in Integrative Neuroscience 10(5):16




Racine, E. et al. 2005. fMRI in the public eye. Nature Reviews Neuroscience 6(2): 159–164.




Racine, E. et al. 2010. Contemporary neuroscience in the media. Social Science and Medicine 71(4): 725-733.



Schlaepfer, T. E., and Fins, J. 2010. Deep brain stimulation and the neuroethics of responsible publishing, when one is not enough. JAMA 303: 775–776.




Servello D., et al. 2010. Long-term, post-deep brain stimulation management of a series of 36 patients affected with refractory gilles de la tourette syndrome. Neuromodulation 13(3): 187-194.




Tir, M. et al. 2007. Exhaustive, one-year follow-up of subthalamic nucleus deep brain stimulation in a large, single-center cohort of parkinsonian patients. Neurosurgery 61(2): 297-305.




van Lente, H. et al.2013. Comparing technological hype cycles: Towards a theory. Technological Forecasting and Social Change 80(8): 1615-1628.




Woloshin, S. et al. 2009. Press releases from academic medical centers: not so academic? Annals of Internal Medicine 150(9): 613-618.





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Ovadia, D. (2014). Media and social stigma can influence the patient adaptation to neurotechnologies and DBS. The Neuroethics Blog. Retrieved on

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An overview of Neurointerventions and the Law: Regulating Human Capacity (Lawyers, Neuroscientists, Philosophers, and Psychologists in Conversation)

During the weekend of September 12^th,
Georgia State University was home to fascinating conversations between
prominent lawyers, neuroscientists, philosophers, and psychologists. The
challenging, thought-provoking, and interdisciplinary nature of this forum was
condensed within its title: Neurointerventions
and the Law: Regulating Human Mental Capacity.

Image from AJOB Neuroscience

Organized
by the Atlanta Neuroethics Consortium (ANEC), the conference sought debate on
the legal implications of using modern neuro-interventions. Some of the
questions that were raised included, but were not limited to:

• 
  What
  mental capacities does one need in order to be eligible for trial? For
  punishment? For release? For cognitive enhancement?
  


• 
  What
  policies should be in place to control such neuro-interventions?
  


• 
  What
  are the current neuro-interventions used in the courts, and how are they
  regulated?
  


• 
  How
  should we view the relationship between mental capacity and both moral and
  legal responsibility? 

Image
from Knowing Neurons

The
conference gathered many prominent members of the MacArthur Foundation Research
Network on Law and Neuroscience. Some of the participants were Senior
Judge Andre Davis (U.S.
Court of Appeals for the Fourth Circuit), Nita
Farahany (Duke
University), Walter
Glannon (University
of Calgary, Stephen
Morse (University
of Pennsylvania Law School), Justice
David Nahmias (Supreme
Court of Georgia), and Paul
Root Wolpe (Emory
Center for Ethics).




The
conference schedule was structured around four panels, each followed by
“parallel streams” of three 30 to 40 minute long related talks given by panelists
or conference attendees. Panels were released under the form of case studies
that raised valuable questions about the use of neuro-interventions in a legal
context. The format of the panel discussions was dynamic and interactive.
First, each panelist presented his or her own views on the topic, then the
chairs opened discussion among panelists by pointing out specific arguments,
converging or diverging positions, and follow-up questions prompted by the
panelists’ points. Finally, audiences had ample time to ask questions.

Image from The
Jury Expert

More
detailed information about each panel is available here, but following is a summary of each
panel. To better frame the general course of a panel, I will discuss the first
panel in more detail.




Panel 1: Making People Sane Enough for Release




The
case discussed was that of State
of New South Wales v Williamson.
In 1990, a then 20-year old Williamson was sentenced to 24 years of
imprisonment on account of violent sexual assault. He was released after 22
years on supervised parole on the condition of continuing treatment with the
testosterone inhibitor cyprotene in the hopes of reducing the uncontrolled
sexual urges of the offender. The ensuing questions was, “Should a
neurointervention be a condition of release from prison for sex offenders?”.




Chris Ryan, a psychiatrist at the University of
Sydney, and Katrina Sifferd, a philosopher from Elmhurst College,
chaired the first panel. The panelists included a justice on the Supreme Court
of Georgia, two neuroscientists, and two philosophers – testimony to the
interdisciplinary nature of the conference. After the case was presented, Justice Nahmias
remarked – to my surprise – that neuro-interventions such as drug
administration and counseling in Georgia courts are pervasive, and designed to
keep as offenders out of the prisons. Philosopher Farah
Focquart then pointed
out that even though testosterone inhibitors may reduce sexual thoughts, there
is no evidence that they also remove aberrant sexual behaviors in sex offenders.




The
conversation took an interesting spin when the panelists started questioning
the divide between a sexual offender and a sexual offender with a sex disorder:
how does introducing self-control in the equation change the grounds of
culpability? Can we prevent sexual offenses from happening by finding a way to
increase self-control, rather than decreasing sexual urges? Ultimately, the panel
discussion arrived to a new, yet equally pertinent larger question: Is all bad
behavior pathological? Can categories that were previously restricted to the
legal sphere undergo medicalization, and how would that affect legal
responsibility and accountability? All these are intriguing questions that
require interdisciplinary evaluation as that promoted by the Neurointerventions and the Law
conference.




Panel 2: Making People Sane Enough for Punishment




This
panel focused on the case of Scott Panetti, a man suffering from delusional
disorder, schizophrenia, bipolar disorder, and alcohol and drug abuse, who was
sentenced to death after murdering two people. The question raised by this
panel was whether neuro-interventions can and should be used to restore an
inmate’s eligibility for punishment. Follow-up questions included what exactly
constitutes eligibility for execution, and whether federal resources should be
invested in rehabilitating offenders just in order to be able to subject them
to punishment.

Scott Panetti : Image from The Austin
Article

Panel
3: Making People Sane Enough for Trial




The
third panel attacked the highly controversial question of who should diagnose
whether an offender has the mental capacities to withstand trial, and whether
psychosis is always a proof of incompetency. The role and reliability of
science in the courts was evaluated, and panelists concluded that the
consideration of scientific insights within a court of law needs to satisfy
three distinct tiers of reliability: of
the method, of the method with respect to the case in question, and of the
person doing the expert testimony. Interesting corollary discussions explored
the reliability of eye-witness testimony, which has historically been shown to
be limited, particularly for cases in cross-racial cases. From a more
neuroscientific perspective, the panelists evaluated the various methods of
neuro-rehabilitation for schizophrenia such as memory enhancement drugs,
cholinesterase inhibitors, and electroshock therapy.




Two
points made during this panel particularly stood out to me. First, in providing a
legal perspective on this question, Judge Davis made the stimulating remark that the law
is not concerned with our philosophical lives. Second, in discussing the
possible application of fMRI techniques to detect brain activation typical to
lying during testimony (that is, if imaging techniques ever become advanced
enough to reach reliability standards), how could the courts account for a case
in which a particular false event memory is true for the testifier?




Panel 4: Cognitive Enhancement




The
last panel was of particular interest to me. As a current college student, I am
witnessing some of my peers’ desperate and constant search to obtain
prescription medications such as Adderall and Ritalin in order to improve their
academic performance. The use of such drugs, by virtue of providing users with
increased mental abilities, may confer them an unfair academic advantage;
therefore, institutions such as Duke University have categorized the use of
cognitive enhancement drugs as a breach
of academic honesty. The panelists discussed the necessity of policies such
as that instituted by Duke and other ethical implications of cognitive
enhancement.

Image from The
Chronicle

Parallel
Streams




There
were eight distinct sessions of parallel streams, each consisting of three
talks related in one way or another to the topic of the panel discussion. Since
the audience of these talks was generally much smaller than that of the panel
discussions, these panels were a great way to further conversations and allow
more ample time for audience questions. Sometimes, however, it was difficult to
choose one stream in lieu of another.




Poster
Session




The
conference integrated a poster session that attracted students from various
disciplines and institutions. Some of the titles were “Enhancing Brain Activity
Through Cognitive Entrainment”, “Coffee and Cognition”, and “Neuroscience and
its Mind Altering Potential for Marketing”.




Closing thoughts




I was
personally captivated by the interdisciplinary conversations I witnessed at the
conference. As a neuroscience student, I am much more familiar with the
specific tools of neuroscience and their applications than I am with Georgia’s
code of laws, for instance. In that respect, I learned quite a bit about the
legal perspective on mental illness and cognitive enhancement. Furthermore, I
have always been interested in how a fixed code of laws can address individuals
fairly, and Neuro-interventions and the
Law directed my questions towards new directions: Does justice mean judging
an individual against a fixed code applied broadly, or should it take into
consideration, for example, the effects of early childhood trauma on
neurodevelopment? Where should the line be set on this matter so that justice
is upheld?




ANEC’s
mission statement is to “bring together individuals and institutions who are
concerned with the ethical, legal, and social implications of emerging
neuroscience research and technology, and the neuroscientific foundations of
moral behavior”. The Neurointerventions
and the Law conference was a commendable effort to endorse the function of
the new group, and a standing proof to the need of engaging in
interdisciplinary conversation to advance both neuroscience research and the
effectiveness of the legal process. It is
only natural to engage multiple fields: we can only know what is just if we
form an idea of what it means to be human, and philosophy, psychology, and
neuroscience all bring different information towards constructing a more
complete answer.






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Lucaciu, I. (2014). An overview of Neurointerventions and the Law: Regulating Human Capacity (Lawyers, Neuroscientists, Philosophers, and Psychologists in Conversation). The Neuroethics Blog. Retrieved on , from
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Agency Revisited: Dr. Heidi Ravven on Moral Psychology, Ethics and the Myth of Free Will

By Stephanie Hare



Stephanie Hare is a second-year PhD student studying neuroscience at Georgia State University. She is the recipient of the first 2CI Neuroethics Doctoral Fellowship and has research interests in psychiatry, law and the normative impact of neuroimaging research. You can connect with Steph via email at share1@student.gsu.edu or use her Twitter handle, @NeuroSteph.



On September 20, Emory University hosted a book talk and signing with Dr. Heidi Ravven, author of The Self Beyond Itself: An Alternative History of Ethics, the New Brain Sciences and the Myth of Free Will. Dr. Ravven received an unsolicited $500,000 grant from the Ford Foundation to write a book rethinking traditional ethical frameworks and theories of moral agency. As a leading scholar on the work of Baruch Spinoza and Jewish philosophy, Ravven is perfectly situated to recognize socio-cultural assumptions regarding our beliefs about free will and agency, allowing for the consideration of alternative perspectives. For nine years, she performed research on new findings from psychology and neuroscience to gain deeper insight into the fundamental facts about human nature and flourishing, and in turn, what we can and should reasonably expect of each other as moral agents.

Via hamilton.edu

Over the course of her talk, Dr. Ravven aimed to dispel two myths.¹



1. We (moral agents) are predominately motivated to act out of self-interest, and we each make our own choices.



2. Each of us has free will.



To challenge the first claim, Ravven draws on literature from evolutionary neurobiology – especially the work of Dr. Jaak Panksepp – claiming that empirical evidence reveals that we are motivated by much more than selfish motives. Panksepp’s research and theory suggest that each of us comes equipped with a foundational motivational system, which he terms the SEEKING system.² While Panksepp claims that the SEEKING system drives us to pursue certain ends, and is evolutionarily conserved across many (mammalian) species, Ravven draws attention to the fact that this system “not only drives (humans) to protect our bodies but also permeates the mind, which is to say our desires and beliefs.”³



If we consider the SEEKING system in isolation – a system that provides the basis for self-preservation, perseverance and goal-oriented action – we can easily get caught up in the idea that we (human agents) are wholly self-interested. Ravven reasons that this perspective does not provide the whole story since “more often than not, the self we protect is the Group Self rather than the discrete self whose boundaries are our skin”⁴ and that we can think of ourselves as selfy in a groupy kind of way.⁵ Many theories of moral agency do not account for the fact that we are social beings with complex goals and aims, far exceeding the simple motive of self-interest. Ravven shows us that the assumption that individual agents act (exclusively) out of self-interest is oversimplified and inaccurate. Thus, it would suit us to find or develop theories of agency that are compatible with the complexities of goal-oriented action and group decision-making.



In the next part of her talk, Ravven set out to show that free will is a myth. She began by defining ‘free will’ as the idea or notion that “we can make choices and decisions above or beyond our biological inheritance, our cultural and social influences and location, and our present situations.”⁶



Many of us will likely find the claim that free will is false to be unsettling. Ravven reasons that this claim strikes a nerve precisely because free will has become so deeply indoctrinated in our culture that it feels natural to us.⁷ Although it feels natural to us, Ravven argues that free will is “a particularly American and Western way of conceiving of human nature"⁸ and we can trace the origins and development of this belief by looking across the history of philosophy.



As early as the 4^th century, we arguably see the first mentioning of the (free) will in the work of Saint Augustine: “I sighed after such freedom . . . but was bound by the iron of my own choice. The enemy had a grip on my will.”⁹ This Augustinian notion of the will had widespread influence on the work of modern philosophers like René Descartes. Ravven recognizes the foundation for modern notions of free will in Descartes’ theory: “Virtue, according to Descartes, consists in judging what is best and then acting with complete resolve on those judgments. Our virtue is thus our strength of will in shaping the self, the body and the world rather than being shaped by them.”¹⁰

Via usc.edu

But Ravven recognizes that this is just one way to conceptualize human action and agency.¹¹ Furthermore, she thinks that these notions of free will are attributable to a form of magical thinking:

This (way of thinking) is to attribute to the human person a supernatural character . . . [Instead,] we are within nature and not beyond it; we are within social and cultural contexts and not beyond them; and our motives are shaped by all this and our immediate situations as well. We are of the world and not beyond it . . . our inner selves and the outer environments and contexts are mutually constitutive.¹²

Here, Ravven’s central aim is to show that this widespread idea that we act above and beyond nature and nurture to exercise a free will is grossly incompatible with what we know about human nature and functioning. So what does this mean for ethics?



If Ravven’s arguments are compelling, then we have reason to call into question at least two assumptions that often serve as the cornerstones of dominant theories of moral agency: (1) We predominately act out of self-interest and make individual choices, and (2) each of us has free will. If Ravven is right, the field of ethics may be in need of a major overhaul — we will likely have to re-conceptualize these theories of moral agency in light of what we know (and what we continue to learn from the sciences) about ourselves as human beings.





Footnotes



¹ This list is not intended to be exhaustive. For example, Ravven also attempts to dispel the myth that there is an innate moral module in the brain, drawing on the work of Jesse Prinz and other researchers in the field of neuroplasticity. For her take and interpretation of Prinz’s arguments, see pp. 261-263 of her book: Ravven, H. (2013). The Self Beyond Itself: An Alternative History of Ethics, the New Brain Sciences and the Myth of Free Will. New York: The New Press.

² Panksepp, J., Biven, L. (2012). The Archaeology of Mind: Neuroevolutionary Origins of Human Emotions. New York: W.W. Norton & Company, Inc., p.95.

³ Ravven, personal communication, 29 October 2014.

⁴ Ibid.

⁵ Here Ravven borrows jargon from Stephen Colbert’s notion of truthiness, to discuss aspects of human nature — namely our selfiness and groupiness.

⁶ Ravven, personal communication, 29 October 2014.

⁷ Ravven, 2013, p. 3.

⁸ Ibid.

⁹ Augustine. (1992). Confessions. Oxford: Oxford University Press, p. 140.

¹⁰ Ravven, 2013, p. 180.

¹¹ Baruch Spinoza was born only 36 years after Descartes. Yet, in his great work, The Ethics, Spinoza repeatedly challenges Descartes’ notion and account of free will. Spinoza even expresses astonishment that “this illustrious person” embraced in free will, “a view which I could scarcely have believed to have been put forward by such a great man.”  In embracing free will, Spinoza continues, Descartes “adopt[ed] a theory more occult than any occult quality” of the Scholastics (Spinoza, B. (1982). The Ethics and Selected Letters. Indianapolis: Hackett Publishing: Part V Preface, p.204).  Influenced by Aristotle and Jewish philosophers like Maimonides, Spinoza had a completely different vision of ethics and agency.

¹² Ravven, personal communication, 29 October 2014.

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Hare, S. (2014). Agency Revisited: Dr. Heidi Ravven on Moral Psychology, Ethics and the Myth of Free Will. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2014/12/agency-revisited-dr-heidi-ravven-on.html

Drug and Alcohol Abuse Among Physicians: How Concerned Should We Be?

By John Banja 



John Banja, PhD is a medical ethicist at Emory University’s Center for Ethics, a professor in the Department of Rehabilitation Medicine, and the editor of AJOB Neuroscience.




In next month’s (December, 2014) issue of the American Journal of Bioethics, I’ll have an article appear on drug and alcohol use among health professionals. My paper is a counter-argument to one that appeared in JAMA in 2013,¹ which recommended that physicians who are involved in serious, harm-causing medical errors should be drug and alcohol tested on the spot. Now, I’ve studied the occurrence of medical errors for over a decade, and the more I thought about that proposal, the more I thought it was a bad idea. So I wrote the article, sent it to AJOB, and eventually it was accepted.²



The point of this blog post is to discuss something that stems from what I learned from the literature on drug and alcohol abusing physicians: most of them can go years, even decades, without the drug or alcohol abuse seriously affecting their work life or technical skills. Physicians who abuse alcohol—which is the most commonly abused substance—can go decades without anyone noticing performance deterioration.³ And when I asked an anesthesiologist recently about the second most popularly abused drugs, oxy- or hydrocodone based narcotics, and how long she thought a physician can be on them without anyone noticing, she pursed her lips and quietly said, “years” (although this doesn’t include intravenous injection of narcotics, where the impact on performance will probably become noticeable in months.)^3-5




The hit Cinemax series “The Knick” loosely based its central character, Dr. John Thackery, on William Halsted, arguably America’s greatest surgeon at the beginning of the 20^th century. Like Freud, Halsted became addicted to cocaine in the 1880s, but whereas Freud kicked his habit around the time of his writing The Interpretation of Dreams, Halsted never did. He suffered from a cocaine-morphine addiction for 30 years, consuming up to 195 milligrams of morphine a day at the height of his use. Yet, only his Hopkins colleague William Osler claimed to have ever seen him the worse for it (and only once) although we know Halsted’s health and general psychological equilibrium were not in good shape during those decades.⁶

William Halsted

(From the Medical Archives of the Johns Hopkins Medical Institutions)

So, while I continue to believe that drug testing physicians in the wake of their involvement in a medical error is a poor use of a health care organization’s resources—random drug testing among clinical personnel is a much better approach for a variety of reasons ^2,4,5—I remain befuddled about the effect of a health professional’s drug or alcohol use on his or her performance levels. How many are using illicit drugs just to maintain their levels of competence? How widespread is such a phenomenon and for how long do professionals do it? Would some users experience a serious decline in their performance levels if they stopped using? Do many, like Halsted, titrate their drug use so that they don’t succumb (or they delay succumbing) to the substance’s negative effects while gaining the maximum performance effect from their habit? How many start and stop at will, or use for extended periods when the going gets rough and then abstain for extended periods when life gets better? Would some who’ve never used benefit from drug use?—which perhaps isn’t as preposterous as it sounds. In neuroethics, we joke about a surgeon in the not-too-far-off future saying to a family, “The operation I’m about to perform on your loved one will take many hours and be very complex. Even though I’ve performed it numerous times, I find that when I take the drug modafinil—which ramps up wakefulness and alertness—I feel more confident and experience no fatigue whatsoever. Nevertheless, I don’t want to abuse the stuff. So, if you’d like me to take a dose before I begin your loved one’s operation, I will, but I’ll have to charge you an additional $500. What would you like me to do?”




I’ve also come across data suggesting that 80 percent of persons who abuse narcotics, especially street folk, don’t develop a habit.⁷ They can quit if they want to but like most physicians who abuse drugs or alcohol, they use to self-medicate. I wonder, therefore, about whether we’re developed an exaggerated and unreasonable fear of these substances, at least for the majority of people. But just saying that sounds reckless and stupid, given the way serious addiction wrecks communities and people’s lives. Still, the rate of drug and alcohol abuse among physicians is around 10 to 12 percent, mirroring the general population’s, implying that about 80,000 doctors are abusing drugs or alcohol right now.^3-5




While the last thing I’d want is for my physician or dentist’s performance to be affected by drugs or alcohol, the purely curious and inquisitive side of me wonders how often it’s already happened and what difference it made. And if we aspire to a rational policy about drug use and abuse, it seems to me these questions deserve a look, especially as we ramp up our physician health programs all around the country.





References



1.  Pham, J. G., P. J. Pronovost, and G. E. Skipper. 2013. Identification of physician impairment. JAMA 309: 2101-2102.

2.  Banja, J. 2014. Alcohol and Drug Testing of Health Professionals Following Preventable
Adverse Events: A Bad Idea. The American Journal of Bioethics, 14(12): 25-36, 2014.

3.  Cicala, R.S. 2003. Substance abuse among physicians: What you need to know. Hospital Physician, July 2003: 39-45.

4.  Berge, K. H., M. D. Seppala, and A. Schipper. 2009. Chemical dependency and the physician. Mayo Clinic Proceedings 84: 625-631.

5.  Merlo, L.J. and M.S. Gold. 2009. Successful treatment of physicians with addictions. Psychiatric Times. Available at http://www.psychiatrictimes.com/addiction/successful-treatment-physicians-addictions.

6.  Markel H. 2011. An Anatomy of Addiction. New York, NY: Pantheon Books.

7.  Hart C. Sept. 16, 2013. The rational choices of crack addicts. New York Times. Available at http://www.nytimes.com/2013/09/17/science/the-rational-choices-of-crack-addicts.html?pagewanted=all&_r=0.






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Banja, J. (2014). Drug and Alcohol Abuse Among Physicians: How Concerned Should We Be? The Neuroethics Blog. Retrieved on

, from http://www.theneuroethicsblog.com/2014/11/drug-and-alcohol-abuse-among-physicians.html

Can Neuroscience Validate the Excuse “Not Tonight, Dear, I have a Headache?"

Men
and women experience fluctuations in sexual motivation over a lifetime. Whether
sexual desire is enhanced or diminished at any particular time can depend on a
number of factors and circumstances, but researchers from McGill University
recently set out to determine specifically how pain impacts sexual behavior.¹ Results from this study, published in The Journal of Neuroscience earlier this
year, were the topic of the most recent “Neuroethics and Neuroscience in the
News” discussion facilitated by Emory Women’s
Gender and Sexuality graduate student Natalie Turrin and Neuroscience
graduate student Mallory Bowers.




To study how pain impacts sexual
motivation, researchers used a partitioned Plexiglas chamber where the
partition contained small, semi-circular openings only large enough for the
female mice to pass through (this study required that male mice be greater than
45 g and female mice smaller than 25 g). In this set-up, the females were free
to either cross the partition and engage in sexual activity with the male mice
or “escape” to the side where the males were unable to follow. Sexual
motivation in this study was measured by how many total mounts occurred, and since
mounting involves male participation, time spent on the male side of the
chamber was also a measure of female sexual motivation. When researchers
injected female mice with inflammatory agents in the vulva, hind paw, tail, or
cheek to induce pain, female mice consistently participated in less mounting
behavior and spent less time on the male side of the cage compared to no
injections. Males, on the other hand, when injected with the same inflammatory
agents in either the penis, hind paw, tail, or cheek, experienced unimpeded
sexual activity (total number of mounts did not decrease compared to controls) in
an open field paradigm where the males had unrestricted access to the females. Although
it has been observed that female mice can have a higher sensitivity to pain
than male mice,² researchers observed that male and female
mice exhibited the same level of sensitivity towards inflammation to the hind
leg according to the mouse grimace scale (MGS), a visual observation of a mouse’s facial
features to determine pain levels.




The final experiments to study sexual
activity involved rescuing the lack of sexual motivation from female mice using
either an antinflammatory agent or two different prosexual drugs. The analgesic
pregabalin reversed the reduction of total mounts that resulted from inducing
pain in females, and according to the MGS, also reduced the level of pain. “Prosexual”
drugs, apomorphine (APO) and melanotan-II (MT-II), had the same rescuing effect,
but based on the MGS, did not have the ability to relieve pain from the
inflammatory injections. It should be noted though that APO increases
locomotion³ in mice, which may partially account for
the females moving towards the male side of the cage more often.




From these experiments, researchers
concluded that female mice have lower levels of sexual motivation when in pain,
but even in penile pain, male mice maintain a desire to participate in sexual
activity. However, the decrease in sexual motivation can be rescued in females
by either pain reduction or aphrodisiacs,
in this case a dopamine agonist (APO) or an α-melanocyte-stimulating hormone
analog (MT-II). Perhaps these claims made regarding mice are reasonable, but it
is even more problematic that the authors confidently extrapolate the results
to humans. The final line of the abstract reads “These findings suggest that the well known context sensitivity of the
human female libido can be explained by evolutionary rather than sociocultural
factors, as female mice can be similarly affected.”




Of course, media outlets ran with this
conclusion and multiple articles were published with definitive titles like “Women ARE more likely to go off sex when
they are in pain” and “That headache excuse is real: For females,
pain kills sexual desire.”
The authors of this paper perpetrated the idea that a woman’s lack of sexual
motivation at any given moment is
either a biological or
a sociocultural one. In the press release and the paper, the authors refer to the
apparently common aphorism “Not tonight, dear, I have a headache,” and mention
that this would be evidence that sometimes wives are in too much pain to have
sex that has been initiated by their husbands. But sexual relations are so much
more complicated than just a simple relationship such as a pain from a headache
equals lack of sexual motivation. What if the woman (or man, for that matter)
doesn’t really have a headache, but there is another underlying reason that a
partner is too embarrassed to share? Or, what if pain from a headache makes you
feel less sexy, and that feeling is the sexual deterrent, not the pain alone? Pain,
either directly or indirectly, would most likely make a person feel less
sexual, but why does is take a study with mice (who aren’t insecure about love
handles or annoyed with a spouse due to an insensitive comment) to validate
this thought? It is reminiscent of neuro-realism, the
idea that attaching a brain scan to any study or correlation suddenly qualifies
the findings as real or more true.⁴ While this study only involved mice,
researchers did use fMRI to study the difference between the brains of women
with and without acquired hypoactive sexual desire disorder (HSDD) in this paper.⁵ But no one - including females, their sexual
partners, researchers, or doctors - really wins when it is being advertised
that the female libido is something that can be can characterized as either
biologically or socioculturally driven. 

Via The Telegraph

One reason for ascribing a biological reason
to the lack of sexual motivation could involve drug development; if a
biological target can be found that is responsible for diminishing sex drive,
then perhaps there is a pill to fix that. The work in the paper was supported
by a Pfizer Pain Research Award from Pfizer Canada, and Pfizer Canada did
kindly provide the pregabalin that was used in the sexual recovery research. There
have been a number of pharmaceutical companies that have sought FDA approval
for low female sexual desire,⁶ even when the diagnosis of disorders such as
HSDD and female sexual dysfunction (FSD) are controversial. One example though
is Lybrido, a drug meant to treat HSDD. (Mallory actually gave a journal club talk last year about the implications of pharmaceutical
companies targeting the female sex drive with a focus on Lybrido). Lybrido
is interesting because it was ineffective in a cohort of women who “suffer from
HSDD as a result of inhibitory mechanisms,” resulting from negative
associations with sex and for that reason Lybridos was developed.⁷ Lybidos has an additional
component that targets the prefrontal cortex areas of the brain and is meant to
alleviate these inhibitory mechanisms.⁸ A discussion of drug
development for women that have negative associations with sex is beyond the
scope of this post, but the mentality that this could be relieved with only a
pill is grossly overly simplifying the complexities of the female libido and
how this affects relationships women have with their sexual partners. If
researchers in academia though are willing to commit to the idea that female
sexuality can be classified as solely biologically determined, then can we
really expect that pharmaceutical companies, marketing campaigns, and sensationalized
news articles won’t try to capitalize on that idea?

Via The Neurocritic

References 

(1)  Farmer, M. A.; Leja, A.; Foxen-Craft,
E.; Chan, L.; MacIntyre, L. C.; Niaki, T.; Chen, M.; Mapplebeck, J. C. S.;
Tabry, V.; Topham, L.; Sukosd, M.; Binik, Y. M.; Pfaus, J. G.; Mogil, J. S.
Pain Reduces Sexual Motivation in Female But Not Male Mice. J. Neurosci.
2014, 34, 5747–5753.

(2)  Mogil, J. S. Sex
Differences in Pain and Pain Inhibition: Multiple Explanations of a
Controversial Phenomenon. Nat. Rev. Neurosci. 2012, 13,
859–866.

(3)  Horn, C. C.;
Kimball, B. A.; Wang, H.; Kaus, J.; Dienel, S.; Nagy, A.; Gathright, G. R.;
Yates, B. J.; Andrews, P. L. R. Why Can’t Rodents Vomit? A Comparative
Behavioral, Anatomical, and Physiological Study. PLoS ONE 2013, 8,
e60537.

(4)  Racine, E.; Bar-Ilan,
O.; Illes, J. fMRI in the Public Eye. Nat. Rev. Neurosci. 2005, 6,
159–164.

(5)  Woodard, T. L.;
Nowak, N. T.; Balon, R.; Tancer, M.; Diamond, M. P. Brain Activation Patterns
in Women with Acquired Hypoactive Sexual Desire Disorder and Women with Normal
Sexual Function: A Cross-Sectional Pilot Study. Fertil. Steril. 2013,
100, 1068–1076.e5.

(6)  Shames, D.; Monroe,
S. E.; Davis, D.; Soule, L. Regulatory Perspective on Clinical Trials and End
Points for Female Sexual Dysfunction, in Particular, Hypoactive Sexual Desire
Disorder: Formulating Recommendations in an Environment of Evolving Clinical
Science. Int. J. Impot. Res. 2006, 19, 30–36.

(7)  Lybrido
http://www.emotionalbrain.nl/lybrido (accessed Oct 30, 2014).

(8)  Lybridos
http://www.emotionalbrain.nl/lybridos (accessed Oct 30, 2014).

Want to cite this post?




Strong, K. (2014). Can Neuroscience Validate the Excuse “Not Tonight, Dear, I have a Headache?" The Neuroethics Blog. Retrieved on

, from http://www.theneuroethicsblog.com/2014/11/can-neuroscience-validate-excuse-not.html

Neural Prosthetics, Behavior Control and Criminal Responsibility

By Walter Glannon, PhD



Walter Glannon is a professor of philosophy at the University of Calgary where he holds the Canada Research Chair in Biomedical Ethics and Ethical Theory. He is also a member of the AJOB Neuroscience editorial board.



Philosophers have argued that moral and criminal responsibility presuppose that actions cannot result from sequences that bypass agents’ control of their mental states as the causes of their actions (A. Mele, Autonomous Agents, 1995). Agents must act from their own mechanisms, which cannot be influenced by drugs, electrical stimulation of the brain, brainwashing or other interventions (J. M. Fischer and M. Ravizza, Responsibility and Control, 1998). Moral and criminal responsibility excludes all forms of brain manipulation.

Via thejuryexpert.com

With deep-brain stimulation (DBS) and brain-computer interfaces (BCIs), neuroscientists can alter the brain and the mental capacities it mediates. The first device modulates dysfunctional neural circuits causing neurological and psychiatric disorders through electrical stimulation of targeted sites in the brain. The second allows people with extensive paralysis to bypass the site of injury and translate intentions into actions by transmitting signals from the motor cortex to a computer. Because these devices and the practitioners who implant and activate them manipulate the brain and mind, the philosophical argument noted above suggests that they undermine the mental control necessary for criminal responsibility. Yet by modulating, bypassing or replacing damaged or dysfunctional regions of the brain, they can restore the mental capacities necessary to form and execute action plans. By enabling rather than disabling these capacities, neural prosthetics allow people to regain enough control of their thought and behavior to act autonomously and be responsible for their actions. Moral and criminal responsibility does not depend on brain function or dysfunction as such but on whether or to what extent the brain enables or impairs the mental capacities necessary for behavior control. In cases of brain injury or disease impairing these capacities, brain implants may restore some of this control. Theoretically, it does not matter whether mental states and events are generated and sustained by a natural or artificial system, provided that agents identify these states and events as their own and is what moves them to action. Artificial devices implanted to regulate thought and behavior are not necessarily alien to the agent but can be considered as a type of expanded embodiment. They can ensure that the agent is the source of her actions. Brain- and mind-altering devices should make us reconsider the meaning of ‘autonomy,’ ‘ownership’ and ‘control’ in discussions of moral and criminal responsibility.



To be criminally responsible for an action, an agent must have the requisite mens rea (“guilty mind”) and perform the requisite actus reus (“bad act”). According to the first criterion, the agent acts with the appropriate mental states corresponding to the definition of the criminal offense. These include intention, knowledge, negligence or recklessness. According to the second criterion, the agent voluntarily performs an intentional bodily movement in committing the offense. The agent’s mental states explain the action insofar as they cause it, and thus the mental basis of responsibility is distinct from the physical content of responsibility, what one is responsible for. Some neural prosthetics should also make us reconsider the relationship between mens rea and actus reus and the distinction between the mental basis and the physical content of responsibility. With these devices, what an agent is criminally responsible for might not be a bodily movement but a mental act. For example, a severely paralyzed subject using a BCI cannot perform any bodily movement and has to plan how he will move a robotic arm or computer cursor in translating his intention from electrodes placed on his scalp or implanted in his motor cortex to a computer. His execution of the intention is a mental act and is something for which he could be criminally responsible. Suppose that the subject is frustrated with the slow pace at which he is learning how to operate the robotic arm but is adept enough in operating it to assault the practitioner training him. In this case, there is no bodily movement but a mental act of executing an intention to move the robotic arm in a certain way. The execution of the intention is not the cause of the guilty act but is the guilty act itself. While the agent is also responsible for moving the robotic arm, this is not the only event for which he is responsible. The assault with the robotic arm could even be described as the consequence of his mental act that is the actus reus.

Via Buchen 2012

Neural prosthetics may also generate obligations that do not apply to people with normal brain function. Suppose that a person with a DBS system implanted in his brain is able to turn off the stimulator. This could cause a return of motor symptoms in a neurological disorder or affective and cognitive symptoms in a psychiatric disorder. In both cases, the decision to turn off the stimulator could cause the person to lose control of her thought and behavior. If she committed a criminal act while incapacitated, then she could be criminally responsible for the action on grounds of negligence or recklessness in foreseeing but ignoring the risks of deactivating the device. The agent failed to discharge her obligation to keep the stimulator on. In some respects, this is similar to being criminally responsible for injuring a pedestrian while driving under the influence of alcohol. But what is different in this case is that having the device in one’s brain seems to generate an obligation to keep it on at all times, an obligation generated by a disease over which the individual had no control.




In sum, there are at least three respects in which neural prosthetics should make us reassess how we think of responsibility and obligation. They challenge the view that manipulation of the brain and mind always undermines the control necessary for responsibility and recommend a broader interpretation of autonomous agency. By including mental acts in the content of responsibility, they also raise questions about the distinction between mens rea and actus reus as a mental-physical distinction and the identification of a guilty act as a bodily movement. And they may generate obligations regarding behavior control that people with devices implanted in their brains would not have had but for a neurological or psychiatric disorder.






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Glannon, W. (2014). Neural Prosthetics, Behavior Control and Criminal Responsibility. The Neuroethics Blog. Retrieved on

, from http://www.theneuroethicsblog.com/2014/11/neural-prosthetics-behavior-control-and.html

Gearing up for the International Neuroethics Society Conference!

2014 INS Annual Meeting

November 13 & 14 in Washington, D.C.

There is still time to register for the annual International Neuroethics Society Conference.



The schedule can be found here.



Learn the latest on the United States National Institutes of Health BRAIN Initiative and the European Commission Human Brain Project. Hear about international case studies of neuroscience in the courtroom, discuss human rights in the neuroethics dialogue AND engage in networking opportunities during breakfast, lunch and two receptions.



Speakers include NIH Directors, representatives from Congress, co-director of the Human Brain Project and a representative from the US Presidential Commission for the Study of Bioethical Issues.



Public Event on November 13: "Neuroscience Knowledge & the Robotic Mind."

We kick off our meeting with a thought-provoking public event on November 13 from 5 - 7 p.m.



All-day Annual Meeting on November 14: Speakers include

• Paul Catley, Open University, UK; 


• Jennifer Chandler, University of Ottawa; 


• Lisa Clayton, University of Manchester; 


• Katy deKogel, Dutch Ministry of Justice; 


• Nita Farahany, Duke University; 


• Chaka Fattah, US House of Representatives; 


• Stephen Hauser, President's Commission for the Study of Bioethical Issues; 


• Tom Insel, National Institute of Mental Health; 


• George Koob, National Institute on Alcohol Abuse & Alcoholism; 


• Story Landis, National Institute of Neurological Disease & Stroke; 


• Alan Leshner, American Association for the Advancement of Science; 


• Geoff Ling, Defense Advanced Research Projects Agency; 


• Henry Markram, Human Brain Project; 


• Steven Marks, Harvard University of Public Health; 


• Barbara Sahakian, Cambridge University & INS President; 


• John Williams, Wellcome Trust 

Check the website for updates www.neuroethicssociety.org 



Both events take place at the award-winning American Association for the Advancement of Science (AAAS) Building, 12th & H Streets, NW. Washington, D.C. Space is limited!

What is uniquely human? A report from The Social Brain Conference

Photo credit: Anders Gade

By James Burkett



James Burkett is a 2014 recipient of the Emory Center for Ethics Neuroethics Travel Award. He is a graduate student in Emory's Neuroscience program, conducting research on social attachment and empathy in Dr. Larry Young's lab.

This October 5^th thru the 8^th I had
the pleasure of attending the Federation of
European Neuroscience Societies’ (FENS) bi-annual Brain
Conference, held in Copenhagen, Denmark. FENS represents the neuroscience
societies of 42 different societies in 32 countries, and is the primary
organization for neuroscience in Europe. The conference, titled “The Social
Brain,” focused on how the brain produces and is affected by social behaviors
in humans and in animals. Chaired by eminent scientists Sarah-Jayne Blakemore
(Director of the University College London’s Institute of Cognitive
Neuroscience), Frans
de Waal (world-famous primatologist at Emory University), and Giacomo
Rizzolatti (discoverer of mirror neurons at University of Parma, Italy),
the conference brought together a wide array of human and animal researchers at
the top of their fields. Throughout the conference, this bipolar grouping was
frequently brought to the same question: what is it that makes humans different
from animals? What is uniquely human? As with a sculpture, this conference
seemed to answer this question by chipping away at the monolith of things
commonly thought of as unique to the human species.

For a long time, humans were thought to be unique for their
tool use [1,2]. However, many surprising examples of tool use have now been
seen in animals. Chimpanzees are now known to fashion weapons for use in
hunting, as well as using tools for nut cracking and termite retrieval; and will
sometimes be seen carrying favorite tools for great distances [1]. Even this
behavior is not unique to apes, however: Caledonian crows also craft and use
tools for grub
retrieval, and even have local tool-making traditions
they pass on to the next generation [2]. There are now many internet videos
showing crows solving
extremely complex tasks with available tools.

Several speakers showed that the human species is not unique
in its ability to cooperate and to understand cooperative relationships [1,3,4].
Chimpanzees, for instance, are perfectly capable of learning cooperative tasks
without training, and even spontaneously develop individual styles, preferred
partners, reputations, and feedback between partners on their choices [1]. They
may do this through the use of specialized “mirror neurons,” which are present
in motor planning and emotional areas of the brain and fire both when an action
or emotion is being experienced, and when it is being observed in others [3,4].
These mirror neurons were first discovered in Rhesus macaques, but have since
been found in humans and chimpanzees. Elephants readily learn cooperative
tasks as well, even waiting for their partner to arrive when a task is
presented that cannot successfully be performed alone [1]. Even more distant
from humans was a striking example of inter-species cooperative hunting between
groupers and moray eels,
where groupers show signs of shared intentionality and referential gesturing in
order to get moray eels to help them catch fish [5]. Tiny 5 gram cleaner wrasses, which
have more than 2,000 inter-species social interactions a day while cleaning
parasites off of other fish, show signs of cooperative strategies, individual
recognition, social prestige, audience effects, tactical deception and
reconciliation.

If an animal naturally cooperates, it should also be
sensitive to the results of cooperation, and there is now ample evidence that
this is the case. In a now-famous experiment, capuchins were shown to be
sensitive to unfairness:
when rewarded for a task with cucumber, they eagerly accept; but when they see
another capuchin being rewarded for the same effort with a grape, they bitterly
refuse the cucumber [1]. This sensitivity to inequality has since been seen in
many other species, including dogs and birds, and may be a general and
necessary behavior in cooperative species. Chimpanzees take this one step
further by showing a sense of fairness as well, choosing to reward others when
there is no benefit to themselves, and sometimes refusing a reward unless a
partner is also rewarded.

Photo credit: Anders Gade

Social animals also employ very similar tactics to humans in
the maintenance of their relationships [1,6]. In social groups, conflicts are
inevitable, and for many years ecologists thought that conflict served to break
bonds of attachment and disperse social groups. However, more recent research
has demonstrated time and again in many species that social group members
actively reconcile after fights, which actually serves to bring group members
together and strengthen bonds. Risky pro-social interactions with new group
members may also serve to help form new social bonds [6]. In some species,
consolation happens after fights as well, typically initiated by individuals
with close relationships with the loser. These consoling behaviors have been
seen in many great apes, dogs, birds and elephants. In addition, recent
experiments in rats show that they are motivated to help their trapped
cagemates escape from an enclosure, and once they learn to do so, they will
release them very quickly even if they receive less of a food reward after
doing so [7]. Finally, the same brain neuropeptides that mediate social
behavior and social bond formation in animals seem to influence human
relationships as well, suggesting a common evolutionary origin for these
mechanisms in the brain [8].

In a talk presenting my own thesis work, I discussed
evidence of consolation in the prairie vole, a highly social monogamous rodent
[9]. Through a series of laboratory experiments, I demonstrated that male
prairie voles will show increased partner-directed grooming toward a male
sibling or female partner if that individual has been exposed to stress. I also
showed that observing their stressed cagemates induces stress and anxiety in
male prairie voles, suggesting that their behavior is based on empathy.

In order to console one another, animals must first be
capable to detect each other’s emotional states [1,7,9,10]. This is perhaps one
of the most broadly observed capacities of all, being present in virtually all
mammals and some other species as well. This is believed, at least in mammals,
to have its origins in motherhood. All mammals are raised by a mother, and
those mothers who are sensitive to the emotional signals and needs of their
offspring are more successful at rearing offspring. As an evolutionary result,
nearly all mammals have an implicit awareness of emotional cues, often
extending to other adults of their species. Sometimes this sensitivity even
extends across species, as has been observed in pet dogs that are responsive to
distress in their owners. Empathy shows similar patterns in humans as in other
animals: it is most often extended toward those closest to the subject, and the
more distressed a subject is by emotional displays in others, the less likely
the subject is to extend them help.

Photo credit: Mihaela Vincze

Related to empathy is observational/social learning, or the
ability to learn from watching another individual. This, too, is observed widely
among animal species, ranging from tool making/using techniques, to
child-rearing traditions, to food choices [11]. Some of the most striking
examples include the potato-washingJapanese macaques, which learned from one macaque to start washing the
dirty potatoes that the caretakers provided. Even when clean store-bought
potatoes were substituted, macaques for generations continued to wash their
potatoes in the sea. This also seems to suggest a form of culture in animals, which
pass along socially learned mannerisms to future generations that sometimes
have little or no functional relevance. Indeed, evidence of cultural practices
is quite strong in chimps, and some evidence exists even in rats.

Some believe that humans are unique in their capacity to
think about the mental states of others, an ability sometimes referred to as
“theory of mind.” However, this is also being challenged by clever beasts.
Studies have shown that human children develop theory of mind at exactly the
same age as they develop mirror self-recognition – a capacity which some of the
most advanced animals, including dolphins, elephants and great apes, also show in
adulthood [1]. However, even more convincing are recent experiments in Caledonian crows,
showing that they recognize the difference between a human-operated and a
randomly operated threatening device [2]. Human studies implicate specific
areas of the brain – the temporo-parietal junction, superior temporal sulcus,
and medial frontal cortex – as regions involved in thinking about the
minds of others [12,13]. In studies on Rhesus macaques, analogous brain regions
tend to expand with expanding group size, suggesting that they are involved in
thinking about group members in other species as well [13].  So, even the imaginative capacity of humans
seems not entirely unique.

The answer to the question of human uniqueness could be
something seemingly obvious: language [14]. “Language seems to invade almost
every aspect of cognition,” added Frans de Waal during a free discussion period.
Language itself is a symbolic representation of thought, and the subsequent
reliance on symbolic representations is reflected across a wide range of
cognitive processes, especially those involved in social communication and
learning. However, there is increasing evidence that some bird songs have
characteristics similar to language; that chimps and dogs can understand spoken
language, and may use gestural communication; and that some parrots may be able
to use spoken language in the same way that humans do [14].

Despite all of the shared capacities between animals and
humans, there is still significant resistance, even among scientists, to using
traditionally “human” terms to describe the emotions, abilities and mental
states of animals [15]. Nonetheless, the uniqueness of humanity may be simply a
matter of combination and degree. Redouan Bshary, the
scientist behind the grouper and cleaner wrasse studies, said in his talk that
all animal brains represent a set of solutions to ecological problems [5]. When
an ecological problem can best be solved through a single mental capacity, you
are likely to find an animal that possesses that capacity. However, you might
find it in isolation – for instance, a grouper that can form shared plans and
make referential gestures toward a moray eel may not be able to think
abstractly, imagine the thoughts of others, or use tools. Each animal
independently evolves only those capabilities it needs for its own set of
ecological problems. Furthermore, while chimps and crows may build tools, and
dogs and birds may understand language, they are nowhere near to matching
humans in the degree to which these capabilities are developed. So, humans may
represent a unique evolutionary amalgam of capabilities that individually can
be seen elsewhere, but rarely all together, and never to the same degree.

Bibliography

[1] de Waal FB (2014 October). Mammalian origins of empathy and pro-sociality. Talk presented at
The Social Brain Conference, Copenhagen, Denmark.

[2] Gray R (2014 October). Can social and technical intelligence be decoupled? Cooperation, causal
cognition and inferences about agency in New Caledonian crows. Talk
presented at The Social Brain Conference, Copenhagen, Denmark.

[3] Ferrari PF (2014 October). Hard-wired, soft-wired and re-wired. Brain plasticity, sensorimotor experience
and early social development in primates. Talk presented at The Social
Brain Conference, Copenhagen, Denmark.

[4] Rizzolatti G (2014 October). Understanding others from inside: a neural mechanism. Talk
presented at The Social Brain Conference, Copenhagen, Denmark.

[5] Bshary R (2014 October). The social brain hypothesis applied to fishes. Talk presented at
The Social Brain Conference, Copenhagen, Denmark.

[6] Calcutt S (2014 October). Chimpanzees in newly formed social groups choose high-risk social
investments over low-risk ones. Talk presented at The Social Brain
Conference, Copenhagen, Denmark.

[7] Mason P (2014 October). Helping another in distress: Lessons from rats. Talk presented at
The Social Brain Conference, Copenhagen, Denmark.

[8] Young LJ (2014 October). The neurobiology of social relationships: implications for novel
therapies for Autism. Talk presented at The Social Brain Conference,
Copenhagen, Denmark.

[9] Burkett JP (2014 October). Consoling behavior in the prairie vole: neurobiology and basis in
empathy. Talk presented at The Social Brain Conference, Copenhagen,
Denmark.

[10] Keysers C (2014 October). The empathic brain and its plasticity. Talk presented at The Social
Brain Conference, Copenhagen, Denmark.

[11] Whiten A (2014 October). Imitation, culture, and the social brains of primates. Talk
presented at The Social Brain Conference, Copenhagen, Denmark.

[12] Mars R (2014 October). From monkey social cognition to human mentalizing. Talk presented
at The Social Brain Conference, Copenhagen, Denmark.

[13] Rushworth M (2014 October). The medial frontal cortex and social cognition in humans and other
primates. Talk presented at The Social Brain Conference, Copenhagen,
Denmark.

 [14] Mooney R (2014
October). Neural mechanisms of
communication. Talk presented at The Social Brain Conference, Copenhagen,
Denmark.

[15] Panksepp J (2014 October). Three primary-process animal social brain
networks 9PANIC, SEEKING, PLAY) and development of three new antidepressants
for humans. Talk presented at The Social Brain Conference, Copenhagen,
Denmark.

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Burkett, J. (2014). What is uniquely human? A report from The Social Brain Conference. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2014/10/what-is-uniquely-human-report-from.html