I know what you’re thinking…

“I know what you’re thinking….”




It’s a common saying and one that belies any functional capacity to predict another’s thoughts. Yet our drive to uncover arguably the most secretive and private form of information – thoughts – has led to major advances in the science of “reading one’s mind.”




Current technologies are able to perform generally accurate predictions about robust neurologic phenomena such as distinguishing if an individual is looking at (or imagining) a face or a home (Haynes and Rees, 2006). However, as technologies advance it may well soon be possible to detect and identify more complex and covert thoughts – lies (Langleben et al., 2005) and even subconscious thought (Dehaene et al., 1998). With this ability, we must question the ethics surrounding the pursuit of this knowledge.

Figure 3 from Haynes and Rees, 2006

The foremost concern with use of this technology is the right to privacy. At what length are we able to sidestep an individual’s basic right to privacy? If an individual is unaware of their thoughts, is it subject to the same privacy rules? In order to even begin addressing this question we would have to establish the nature of privacy as it relates to our thoughts. Popular opinion would hold that thoughts are private, pure and simple, off limits to anyone but those who experience them.




But what of more ambiguous situations?




Would it be ethical to use thoughts as a means of evidence? Conceivably, there would be a push to use this technology to try defendants (Dickson and McMahon, 2005) but we call into question the nature of the information we obtain from a defendant. Perhaps they are experiencing a subconscious thought, rather than actively lying. Is it possible to distinguish between these two states? Even if we could, what is the quality of the evidence garnered? It’s possible that the defendant exhibits thought in a pattern that suggests a lie, when in reality it is the superimposition of both a subconscious thought and a truthful one.




Of further concern, thoughts cannot be assumed to translate to action and so we again must question what the acquisition of a thought means. Take for example the common scenario of road rage. We have all experienced annoyance at a reckless driver that nearly clips your vehicle. In the instant after their car narrowly evades yours, a variety of shock induced thoughts come to mind. Granted while some individuals may put such thoughts to action, a large majority grumbles under the breath and carries on with their day. Knowing that all these people experience similar thoughts after an incident such as this; can we associate a thought in line with road rage to an action in line with road rage? Clearly we cannot as a thought in this case does not equate to action. Thus, returning to the notion of reading these thoughts, what would a read thought mean; how should it be interpreted?




Clearly, most of these concerns address the technical limitations of the technology in its current state (Haynes and Rees, 2006) and so perhaps the mature technology could be limitedly applied to cases such as these. However, no matter how refined the technology we cannot readily solve the dilemma of what thoughts should be read and what should be left to the individual and therein lays our greatest quandary.




Ultimately, I believe we will inevitably come to see the use of this technology in limited realms as we have an important history outlining when privacy can be impinged upon. Notably, cases such as legal wiretapping, or search warrants are justified breaches of privacy. Conceivably this technology will in time be utilized in a similar fashion. In addition, there will cases where individuals either provide consent to having their brain activity recorded or are required by law to do so. Still while these possibilities are near certain, the question remains where we as a society will place limits on using and accessing this information – since while I soon may be able to know what you’re thinking, would we even want to know?




--Gordon Dale






Want to cite this post?


Dale, G. (2012). I know what you’re thinking…. The Neuroethics Blog. Retrieved on

-->, from http://www.theneuroethicsblog.com/






References




Haynes, J., & Rees, G. (2006). Decoding mental states from brain activity in humans. Nature Neuroscience, 7, doi: 10.1038/nrn1931




Dickson, K., & McMahon, M. (2005). Will the law come running? the potential role of "brain fingerprinting" in crime investigation and adjudication in australia. Journal of Law and Medicine, 13(2), 204-22.




Dehaene, S., Naccache, L., Le Clec, G., Koechlin, E., Mueller, M., Dehaene-Lambertz, G., van de Moortele, P., & Le Bihan, D. (1998). Imaging unconscious semantic priming. Nature, 395(6702), 597-600. doi: 10.1038/26967




Langleben, D. D., Loughead, J. W., Bilker, W. B., Ruparel, K., Childress, A. R., Busch, S. I., & Gur, R. C. (2005). Telling truth from lie in individual subjects with fast event-related fmri. Human Brain Mapping, 26, 262-72.

Brain reading and the right to privacy

With advances in neuroimaging the ability to decode mental states in humans by recording brain activity has become a reality. In a review for Nature Neuroscience that is now six years old, John-Dylan Haynes and Geraint Rees detail how fMRI can be used to accurately predict visual perception. They explain that with advanced statistical pattern recognition, not only can the perception of broadly different visual inputs be differentiated, such as faces versus landscapes, but even the perception of subtly distinct objects, such shoes versus a chair, can be recognized. Further, fine details can also be distinguished, including image orientation, direction of motion, and perceived color. Indeed, the orientation of masked images can even be discriminated by activity in the primary visual cortex despite the subject being unable to consciously distinguish the orientation of the image.

Decoding unconscious processing (from Haynes and Rees, 2006)

While the power of fMRI and other imaging techniques to extract information from the brain without the consent of the subject may not yet warrant serious concerns about the subject’s privacy, young neuroscientists face the distinct possibility that during their careers neuroimaging techniques will advance to the point that these ‘non-invasive’ techniques will have the power to invade the subject’s privacy in ways the subject does not want and may not understand. Therefore, young neuroscientists have a responsibility to be prepared to answer the ethical questions that could plausibly arise as a result of their work in the not too distant future.




Major Ethical Questions




The first topic that comes to mind is the question of the use of fMRI for lie detection. This is a popular idea that has even made its way onto Mythbusters with the show concluding that it was plausible to fool the test in its current state. This topic has also appeared previously on The Neuroethics Blog with Dr. Julie Seaman discussing whether fMRI, possibly in conjunction with the polygraph test, could eventually be used to help a jury determine the credibility of a witness. Dr. Seaman points out that thus far courts have been reluctant to allow lie detection tests despite evidence of humans being very poor at determining truth from lies. Use of lie detection may well be desirable to aid an imperfect human system, but several questions arise: What level of sensitivity would need to be achieved before a test should be considered accurate enough for the court room? What happens if a test shows a witness is lying? Can that witness then be tried? Who administers the test? If possible, should the test be fully automated?




While lie detection may be the most dramatic topic, other uses of neuroimaging raise similarly important questions: Should fMRI be used to potentially reveal cognitive functions in fully paralyzed patients? Could prospective employees be asked to submit brain scans as part of job applications? How about politicians running for office? What responsibility do neuroscientists have to filter this information?




The Role of Neuroscientists




Neuroscientists will need to be cautious in reporting results that could potentially lead to abuse related to brain scanning. While scientists may have limited control over the rules established to govern any rights to mental privacy, they are likely to be called upon for expertise in interpreting potentially misleading results. As neuroscience findings become widely publicized certain topics, such as the ones discussed above, may become controversial and neuroscientists have a responsibility to learn from mistakes of the past that have led to public misinterpretation of important scientific findings such as evolution and climate change. Few realms of science have as great a potential to produce as controversial findings in the near future as neuroscience and thus neuroscientists need to discuss ethical implications before they arise and be prepared to responsibly handle the extraordinary powers they may be granted; including the power they may be well be granted to read minds by imaging brains.




--Eric Maltbie






Want to cite this post?




Maltbie, E. (2012). Brain reading and the right to privacy. The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2013/02/brain-reading-and-right-to-privacy.html

Fourth and Final Installment: First Year Neuroscience Students at Emory Write about Neuroimaging and Decoding Mental States

This year, Emory's First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course.



These posts will be delivered in 4 weekly installments, each week
featuring a commentary on a different neuroethics piece. This is the
third of four installments.



This week, we feature the final installment of student blogs covering the following article:



Decoding mental states from brain activity in humans Nature Reviews Neuroscience 7, 523-534 (July 2006)

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Hello! Anybody in there?

At what point can be say without a shout of a doubt that no one is left inside that lifeless corpse laying there motionless in that hospital bed? The first major problem we encounter when discussing “disorders of consciousness¹” is that we still don’t have a definitive definition of what consciousness even is. Is it a tangible mass in the brain? Does it light up in response to stimuli during a brain scan? We are still fighting these issues about people’s mental states and their level of consciousness yet we have no idea what that even is. It seems to be a losing battle that will only end in debate. Some are trying to go a step farther and implement modern technology into the better accessing a patient’s mental abilities and whether or not it is safe to define that as being in a vegetative state.

Premotor cortex activity in a vegetative state (Source)

The reasoning for challenging the standard operation of care is that, in 2008, it was reported that 43% of patients were diagnosed as being “vegetative” when in actuality they should have been classified in one of the other mental states¹. So Owen et al. suggested that another tool to access ones mental awareness could be to use functional magnetic resonance imaging (fMRI) to determine with patients brains could respond to external stimuli or perhaps even more complex mental tasks. They suggested that this not replace the behavioral assessments that are already in practice but an additional resource that may decrease the alarming misdiagnosis rate.




So how this would be used in a clinical situation? Boly et al. describe a way in which a patient was told to image all the motions and actions associated with playing tennis against an imaginary opponent². The goal of this experiment was to compare the areas of the brain the lit up in the vegetative state patients compared to control subject who were asked to perform the same mental task². Surprisingly, the patient showed tremendous activation in the supplementary motor area (SMA) that was comparable to the same patterns found in the control subjects². Does this mean the patient still had higher cognitive processing abilities and should not be defined as being in a vegetative state? The authors of this study decided this was a case in which the patient was misdiagnosed and still retained the ability to processes spoken commands.




I definitely think it is necessary to improve the assessments of patients’ mental state before declaring them as vegetative; however I feel that this is open to interpretation based on the fact that we don’t have a definitive term of what consciousness is. It makes for a difficult argument trying to speak out against a diagnosis when the foundation of that diagnosis isn’t well defined. Perhaps fMRI can help better define this state but with all techniques there comes flaws. For example, are can specific neuronal networks be activated without high order processing? Even though the patients might be in a vegetative state doesn’t necessarily mean that the neuronal networks that process that information are no longer intact and cannot be activated.




--Travis Rotterman






Want to cite this post?


Rotterman, T. (2012). Hello! Anybody in there? The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2013/02/hello-anybody-in-there.html






References




1. Coleman, M. R. and A. M. Owen (2008). "Functional neuroimaging of disorders of consciousness." Int Anesthesiol Clin 46(3): 147-157.




2. Boly, M., et al. (2007). "When thoughts become action: an fMRI paradigm to study volitional brain activity in non-communicative brain injured patients." Neuroimage 36(3): 979-992.

Vegetative States

Functional brain imaging techniques have become a versatile tool for peering into brain and how its activity can manifest as behavior. Nervous system injuries can leave people with varying degrees of functionality and capability. Disabilities can be of the mind such as the inability to perform cognitive tasks like math or impair memory recall or formation. Other injuries can be of the body such as in paralysis or quadriplegia. Unfortunately when it comes to brain injuries, the resulting symptoms are never easily quantifiable. Diagnosis of such patients is complicated by the fact that “There is as yet no universally agreed definition of consciousness and, to an even greater extent, no definition of ‘self-consciousness’ or ‘sense of self/being’“ (Owen and Coleman, 2008). It is thus no surprise that misdiagnosis resulting from brain imaging techniques are as high as 43% (Andrews et al. 1996, Childs et al. 1993). The progression of neuroimaging techniques being used clinically to diagnose consciousness and the vegetative state requires neuroscientists themselves to step up and provide education to clinicians and patients about not only how neuroimaging works but also what it means.

Can fMRI determine consciousness? (Source)

The most commonly used form of neuroimagaing, fMRI, basically extracts information about where energy is being used the fastest in the brain. This in combination with an understanding of what various brain regions do, can provide insight about what it is the brain may be thinking about. It would follow that perhaps neuroimaging could be used as a measure of how conscious a person is whether or not they are visibly awake and moving. This is precisely the complication arising in the case of patients in the vegetative state that while unable to execute commands physically, may still be mentally intact and alert. A recent study asking patients to imagine various scenarios such as playing tennis or walking around a house (Boly et al. 2007) provides ample evidence that brain scans can pick up different responses in brain activity that is question specific. When it comes to applying these techniques to vegetative patients, things get complicated.




The first complication arises from a lack of understanding how fMRI works. Patients families may correlate fMRI activity to consciousness when this may not be the case. For example if a patient is capable of hearing but not thinking about what they have heard, an fMRI may indicate brain activity whenever the patient is spoken to. Thus being able to hear is not the same as being able to process what is heard. The second complication arises from how brain scans and their information should be treated medically and legally. Neuroscientists much take up responsibility in educating clinicians and lawyers about the reliability and accessibility of this technique. For example, using fMRI scans as evidence for consciousness in court may be tenuous due to the high proportion of false negatives that fMRI scans may produce (Owens and Campbell 2008). Thirdly neurosciences have a responsibility in promoting awareness of multi-approach testing for consciousness. Even in science, brain scans are normally used as but a part of behavioral testing. Other measures including EEGs and comprehensive mental evaluations are necessary for augmenting fMRI scans.




While neuroimaging represents a great step toward helping diagnose patients suffering from nervous system damage, there remains much more education and awareness that falls to the hands of neuroscientists, clinicans, lawyers, and patients to make it an efficacious technique for evaluating consciousness.




--Michael Jiang








Want to cite this post?


Jiang, M. (2012). Vegetative States. The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2013/02/vegetative-states.html






Works Cited




Andrews, K., Murphy, L., Munday, R. & Littlewood, C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ 313, 13–16 (1996).




Boly, M. et al. When thoughts become actions: an fMRI paradigm to study volitional brain activity in noncommunicative brain injured patients. Neuroimage 36, 979–992, 2007.




Childs, N. L., Mercer, W. N. & Childs, H. W. Accuracy of diagnosis of persistent vegetative state. Neurology 43, 1465–1467 (1993).




Owens, A. M., Coleman, M. R. Functional neuroimaging of the vegetative state. Nature Neuroscience Perspectives (9), 235-243 (2008).

Ethics, Logic and Vegetative States on a First Date

So, you’re on a first date and you’ve just finished discussing your favorite movies, how many siblings you have et cetera. The next natural topic of discussion will be “how do you feel about functional neuroimaging of the vegetative state?” Don’t be intimidated. Here are three guidelines to follow so that your discussion is intellectually stimulating and does not get stuck in a mire of cognitive biases and gaps in logic.

fMRI Communication? (Source)

1. 
   Avoid the Availability Heuristic: Your date has most likely read over Owen and Coleman’s 2008 review of functional MRI’s ability to upgrade patients from vegetative states to non-behavioral minimally conscious states (Owen and Coleman 2008). It would be impossible for both of you not to think about the 43% chance of misdiagnosis if you’re in a vegetative state (Owen and Coleman 2008). Telling him/her that more recent studies have decreased these misdiagnoses to 41% probably won’t help (Schnakers 2009) It’s important to remember that just because the stories of patients displaying higher cognitive abilities, despite being diagnosed as being in a vegetative state is saliently memorable, does not mean that this is a common occurrence (Coleman, Rodd et al. 2007) (Owen 2006; Boly 2007). Just because they are deemed to have cognitive capabilities, doesn’t mean that they are experiencing “locked-in” syndrome, a terrifying situation in which an individual is fully conscious but unable to move or speak (Owen and Coleman 2008). Don’t assume that everyone who is deemed to be vegetative state is trapped in mental solitary confinement. That’s illogical and not helpful.
   




2. 
   False Dilemma or the Black-or-White Fallacy: You’re date might think you’re a pessimist, but you have to tell him/her that this diagnostic tool is going to be extremely limited at first. These researchers probably receive full inboxes daily from desperate family members looking for hope. Someone will have to decide who will be scanned and who will not. “That’s not fair,” your date says and the best response is this: “I’m sorry, but life isn’t fair. There’s no way that everybody can be scanned and it’s irrational to deny fMRI scanning until availability is ubiquitous. Let’s not make this an all-or-nothing choice. I think the correct choice is c) some people get scanned and benefit from the technology. This is better than no one getting scanned. In the mean time, this has to be. But there’s hope, a rising tide lifts all boats.” And this isn’t a foolproof diagnostic tool. Do you know how easy it is for healthy participants to fall asleep in a scanner? Now imagine that you have a traumatic brain injury. False-negative findings are a high likelihood with traumatic brain injury patients (Owen and Coleman 2008).
   




3. 
   Emotions: Your date might go for the jugular of any difficult ethical discussion: pathos/emotions. Queue the violins, apply the soft focus and listen to a tragic tail of one of your loved ones being in a terrible accident. Listen and imagine the fear and sadness that’s felt by anyone who has experienced this type of tragedy. “How would you feel if your [mother, uncle, sister] was in this situation? Wouldn’t you want to keep them alive as long as possible? Would you just give up on them?”… and then snap out of it. You’ll have to explain to your date that it’s natural for topics like this to be emotionally charged due to religious beliefs, personal fears and extrapolations. The fact remains that when you are not emotionally involved is the best time to think about difficult ethical issues. Logic goes out the window when emotions are involved. Families and loved ones in these horrible situations deserve support, help and empathy. Prolonging states of grief, denial or false hope will not help them. If you don’t feel a drink thrown in your face, continue your date.
   

With these tips in mind enjoy getting to know your date and their opinions on this ethical issue, free from logical pitfalls. You are two individuals with full cognitive capacities, unlike the hypothetical individuals in vegetative states you are discussing. Honor those suffering from traumatic brain injury by using your logical capacities to their full extent, while you have them.




--Amielle Moreno






Want to cite this post?


Moreno, A. (2012). Ethics, Logic and Vegetative States on a First Date. The Neuroethics Blog. Retrieved on
, from http://www.theneuroethicsblog.com/2013/02/ethics-logic-and-vegetative-states-on.html






Works Cited




Boly, M. (2007). "When thoughts become actions: an fMRI paradigm to study volitional brain activity in non-communicative brain injured patients." Neuroimage 36: 979-992.




Coleman, M. R., J. M. Rodd, et al. (2007). "Do vegetative patients retain aspects of language comprehension? Evidence from fMRI." Brain 130(Pt 10): 2494-2507.




Owen, A. M. (2006). "Detecting awareness in the vegetative state." Science 313(1402).




Owen, A. M. and M. R. Coleman (2008). "Functional neuroimaging of the vegetative state." Nature 9: 235.




Schnakers, C. V., A.; Giacino, J.; Ventura, M.; Boly, M.; Majerus, S; Moonen, G.; Laureys, S (2009). "Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment." BMC Neurology 9(35).

Third Installment: First Year Neuroscience Students at Emory Write about the Ethics of Neuroimaging of the Vegetative State

This year, Emory's First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course.



These posts will be delivered in 4 weekly installments, each week
featuring a commentary on a different neuroethics piece. This is the
third of four installments.



This week, we feature blogs covering the following article:



Functional neuroimaging of the vegetative state Nature Reviews Neuroscience 9, 235-243 (March 2008).