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Overview
Introduction to Neuroethics
Involved Technology
Ethical Considerations Law, Discrimination/Stigma, Incidental
Findings, Neuromarketing
Summary and Conclusion
Introduction to Neuroethics Advanced understanding and
monitoring of human thought and behavior
Brings new ethical, social and legal issues forward
Enabled by modern neurotechnologies
Introduction to Neuroethics Can now quantify personal behaviors
Social attitude, value and moral agency
Akin to modern genetics Prediction of disease, privacy, identity
Must carefully and properly interpret relationship between brain findings and concept of self
Introduction to Neuroethics Must tackle practical questions in
neuroimaging Interpretation is fundamental
Ethics of genetics are not a sufficient guide
Not apart of traditional bioethical analysis
Introduction to Neuroethics The Good, the Bad and the Anterior
Cingulate (2002) Morals and the Human Brain: A Working
Model (2003) Strategizing the Human Brain (2003) The Medial Frontal Cortex and the Rapid
Processing of Monetary Gains and Losses (2002)
The Neural Basis of Economic Decision-Making in the Ultimatum Game (2003)
Introduction to Neuroethics How the Mind Reads other Minds
(2003) Tapping the Mind (2003) Why We’re So Nice: We’re Wired to
Cooperate (2002) There’s a Sucker Born in Every
Medial Prefrontal Cortex (2003)
Introduction to Neuroethics “Thought maps”
Quantitative profiles of brain function
“Thought maps” Not restricted to medical research and
clinical neuropsychiatry Natural relevance in our daily life
Introduction to Neuroethics Introduces many possibilities/desires
Assessing truth of statements and memory in law
Profiling prospective employees for professional and interpersonal skills
Evaluating students for learning potential
Selecting investment managers to handle financial portfolios
Choosing life partners based on compatible brain profiles
Introduction to Neuroethics Raises a number of epistemological issues
The study of knowledge What is knowledge, how can it be accessed, how
can it be used? Proper interpretation
Scientific level Complexity of neuroscience research – integration
and interpretation of neuroimaging data Social and cultural level
Social interpretations, bound by cultural and anthropological frameworks
Involved Technology
Most prominent tools: Electroencephalography (EEG) Magnetoencephalography (MEG) Positron emission tomography (PET) Single photon emission computed
tomography (SPECT) Functional Magnetic Resonance Imaging
(fMRI)
Involved Technology
1929, Hans Berger Invented electroencephalogram Relative signal strength and position of
electrical activity generated at level of cerebral cortex
Measured using electrodes placed on scalp
Evoked EEG response, “event related potential”
First tool used to reveal fundamental knowledge behind the operation of the human brain in real time
Involved Technology
Other imaging methods took advantage of brain signals Extracranial electromagnetic activity
(MEG) Metabolic activity and blood flow (PET
SPECT) Regional blood oxygenation (fMRI)
All imaging methods use comparison/subtraction between two controlled conditions
Involved Technology
All imaging methods use heavy statistical processing and computer intensive data reconstruction
Ultimately produce the familiar and colorful maps
Used for diagnosis/interventionof trauma, dementia, stroke, etc.
Involved Technology
fMRIs will have greatest impact Widespread availability of MR scanners Imaging approach is non-invasive Model for neuroethical discussions Relative difference between
experimental and control (baseline) task Surplus of oxygenated blood recruited to
relatively active brain regions produces effects measured by MR
Involved Technology fMRI used alone or in combo with previously
mentioned techniques in studies Lying and deception Human cooperation and competition Brain differences in violent people Genetic influences Variability in patterns of brain development
Investigation of unio mysticia using EEG, fMRI, and PET “Spiritual neuroscience”
Continuing on…
Personal neuroprofiles ripe for bioethical consideration
Neuroscience and philosophical questions Existence limits Meaning of free will Distinguishing truth from lies, false
memories from real ones Prediction of behavior
Ethical Considerations - Law 1985 –Ake v. Oklahoma
Glen Burton Ake murdered a couple, wounded their two children
Acted bizarrely in court, prompted judge to order psychiatric competency evaluation
Report resulted in identifying Ake as delusional▪ Claimed to be ‘Sword of Vengeance’ and will sit at the
left hand of God in heaven Diagnosed as probable paranoid schizophrenic▪ Is he competent to stand trial?
Ethical Considerations- Law Ake’s attorney requested the court
appoint a psychiatrist to evaluate him for purpose of insanity defense Criminal defendants argue this should
include scans like PET and MRI
What do you guys think? Does Ake get evaluated?
Ethical Considerations - Law The court says, nope!
Upheld that he had no such right to assistance
Ake was then tried Convicted of 2 counts of murder Sentenced to death
Ethical Considerations - Law Conviction overturned!
Ake was not provided a psychiatrist Deemed unfair trial
Found guilty again, this time just life in prison
Ethical Considerations - Law Should neuroimaging be used regardless
of offences? Do they ‘deserve’ it? Burden of the state? Unfair advantage?
Keep in mind: PET previously has shown poor functioning in prefrontal cortex of criminals Locus of impulse control
Ethical Considerations - Law PET images have been used to argue
that defendant was biologically predisposed to committing a crime
Further argued they should be spared conviction or death sentence
Ethical Considerations - Law 1994 – People v. Jones
Homicide conviction overturned State failed to provide brain scans
1992 – People v. Weinstein Accused of strangling his wife to death,
throwing her body from 12th floor PET, MRI showed arachnoid cyst, used
for insanity defense
Ethical Considerations - Law 1992 – People v. Weinstein
PET scan showed juxtaposition between black cyst and red/green colored “normal” areas
Juxtaposition was apparently “profound”, apparent his brain was not functioning normally
Convicted of manslaughter
Thoughts?
Ethical Considerations - Law 2001 – Langleben et al.
fMRI study Approach to truth verification, “brain fingerprinting” Participants with/without playing cards Boils down to “lying takes more energy” Results consistent with studies done in 1997 and
2003 Can also determine if deception is premeditated
Thoughts? Is brain fingerprinting legitimate? Should it be used in court?
Ethical Considerations - Law Brain fingerprinting
Terry Harrington, convicted of murder of retired police officer in 1977▪ Underwent brain fingerprinting in 2000▪ EEG patterns suggested he was innocent▪ Original prosecution witness recanted
statement when presented with this evidence
Ethical Considerations – Discrimination/Stigma Health information is not entirely
private
This can lead to denial of Health insurance Employment Education Financial loans
Ethical Considerations – Discrimination/Stigma Neuroimaging provides insights into
range of higher cognitive functions Many do not have good animal models Studies touch on areas of profound societal
importance and controversy
Race relations, economic justice, perceived trustworthiness, moral reasoning, economic cooperation, social rejection, consumer brand attachment
Ethical Considerations – Discrimination/Stigma Ability to predict behavior raises
many concerns Mind-reading Social control
Novelty and extent of neuroimaging data gives info on human health, behavior and cognitive fitness Raises concern
Ethical Considerations – Discrimination/Stigma How much of this info will be used to
benefit mankind?
Can the info be used for harm or purposes with ill-intent?
How will neuroimaging affect our daily life? Work, education, financial, social
interactions
Ethical Considerations – Discrimination/Stigma Prediction of future
behavior/pathology
Screening for team players and weak decision-makers in the workplace?
Post-Columbine era Screening students for predisposition to
unruly or violent behavior?
Ethical Considerations – Discrimination/Stigma Post 9/11 era
Screening for terrorists? Perhaps a brain scan at the airport?
Detention of individuals who have not yet committed a crime DSPD – Dangerous Severe Personality Disorder Type I and II errors – statistical threshold Cost vs. detaining past sentence (which can
be legal)
Ethical Considerations – Discrimination/Stigma Pedophiles
January 22nd, 2002 – US Supreme Court states:▪ Can confine violent sexual offenders beyond their
prison term▪ Only if shown they have mental/personality disorder
making it difficult to control behavior
Very likely future imaging studies will be used to determine felon’s ability to control behavior More effective than behavioral test
Ethical Considerations – Discrimination/Stigma So, back to pedophiles!
Megan’s Law Information on sex offenders available to public
What if brain scans can be used to identify potential pedophiles among non-criminal persons Who should scan? How should the data be used?
Should identified persons be registered? Should it be made available to employers?
Ethical Considerations- Incidental Findings Incidental findings
“Observations of potential clinical significance and unexpectedly discovered and unrelated to the purpose of variables of the study”
Found in up to 10% of neuroimaging research
How should they be handled? In what way? What should be done? Abide by legal and ethical principles in
research/medicine
Ethical Considerations- Incidental Findings Risks
Emotional burden, possible unnecessary procedures
Benefits Early detection of something that can be
treated/prevented
How about opportunity to waive right to receive info on incidental findings?
Ethical Considerations- Incidental Findings Case Study!
FE is 65 yo female fMRI volunteer Study is for osteoarthritic knee pain Found to have ischemic changes in left
temporal lobe during brain scan She had no neurological deficit, did not
complain of discomfort
What would you do?
Ethical Considerations- Incidental Findings What actually happened
PI was clinician, decided to disclose findings With her permission contacted physician for follow up
FE developed neurological deficits 24 hours later, underwent repeat neuroimaging and treatment
Diagnosis of ischemic temporal lobe Survived after treatment
Ethical Considerations- Incidental Findings Afterwards, PI and team felt
distressed and unequipped in dealing with incidental findings Wished for clear documentation of
whether patient wanted to be informed Addressed lack of standard guidelines,
protocol, training, knowledge regarding legal and ethical principles
Ethical Considerations- Incidental Findings Canada – all known foreseeable risks (even
rare and remote) must be disclosed to research participants or surrogate decision-maker Guided by Halushka v. University of Saskatchewan
and Weiss v. Solomon No mention of whether foreseeable incidental
findings should be regarded as potential risks/harms No clear guidelines as to when and what to disclose
in best interests of the patient
Thoughts?
Ethical Considerations - Neuromarketing Goal of marketing is to match
products with people Guide design and presentation of
products to increase compatibility with consumers
Facilitating choice process of customer
Neuroeconomics – incorporating neuroimaging into decision-making sciences
Ethical Considerations - Neuromarketing Hope among marketers
neuroimaging will streamline marketing processes while saving money
Obtain customer information that cannot be acquired using conventional methods
Some companies market neuromarketing itself
Ethical Considerations - Neuromarketing More accurately indicate underlying
preferences than standard market data Remains insensitive to biases
Efficiently allocate resources Product concepts tested rapidly Unpromising concepts eliminated early Can now focus on promising products
Ethical Considerations - Neuromarketing Banned in France
Eye-tracking, galvanic skin response still legal
Misinterpretation and over-interpretation an issue
Video: http://www.youtube.com/watch?v=Ajg0ypDD7i0
Ethical Considerations - Neuromarketing Unsettling? Creepy?
Is it ethical? Need to respect autonomy,
confidentiality, privacy Informed consent? Full disclosure of risk
or harm▪ How invasive are the procedures?
What exactly can the data be used for?
Ethical Considerations - Neuromarketing Protecting the vulnerable
Children, psychiatric patients, prisoners Can be easily influenced▪ Easily deceived and/or experience negative
affected
Commercial use of data from these groups Is it justified? Can it be defended?
Ethical Considerations - Neuromarketing Baylor College of Medicine
Pepsi vs. Coca-Cola fMRI showed consumers prefer Pepsi▪ 5x the response in ventral putamen
When repeated unblind…▪ Nearly all participants prefer Coca-Cola▪ Medial prefrontal cortex was activated –
linked to sense of self▪ Brand is so attractive its overriding our taste
buds?
Ethical Considerations - Neuromarketing Are you comfortable with
neuromarketing? Should lines be drawn? Where? What can the information be used for? Do the risks outweigh the benefits? Do we care that much about finding
products that suit us?
Summary Neuroethics is still young
Many unaddressed situations Neuroscience “boomed” in early 21st century
Utilizes neuroimaging EEG, MEG, PET, SPECT, fMRI
Massive impact on bioethics Law, Discrimination/Stigma, Incidental findings,
Neureconomics/Neuromarketing, etc.
Summary
However, brain imaging is extremely useful Understanding how our brain functions,
diagnosis of disease, detecting abnormalities
Interpretation is the key issue Scientific and social level
Should lines be drawn? Where do we draw the line?
References Illes, J., & Racine, E. (2005). Imaging or Imagining? A
Neuroethics Challenge Informed by Genetics. The American Journal of Bioethics : AJOB, 5(2), 5–18. doi:10.1080/15265160590923358
Illes, J., & Bird, S. (2006, July 21). Neuroethics: A modern context for ethics in neuroscience. Retrieved February 12, 2015, from http://neuroethics.stanford.edu/documents/TINSarticle.pdf
Scanning the social brain. (n.d.). Retrieved February 12, 2015, from http://www.nature.com/neuro/journal/v6/n12/full/nn1203-1239.html
Canli, T., & Amin, Z. (2002, December 3). Neuroimaging of emotion and personality: Scientific evidence and ethical considerations. Retrieved February 12, 2015, from http://www.sciencedirect.com.ezpxy.fanshawec.ca/science/article/pii/S0278262602005171
References Lawrence Leung, “Incidental Findings in Neuroimaging:
Ethical and Medicolegal Considerations,”Neuroscience Journal, vol. 2013, Article ID 439145, 7 pages, 2013. doi:10.1155/2013/439145
Ariely, D., & Berns, G. S. (2010). Neuromarketing: the hope and hype of neuroimaging in business. Nature Reviews. Neuroscience, 11(4), 284–292. doi:10.1038/nrn2795
Yesim Isil Ulman, Tuna Cakar & Gokcen Yildiz, Ethical Issues in Neuromarketing: “I Consume, Therefore I am!”, Science and Engineering Ethics, ISSN 1353-3452, Sci Eng Ethics, DOI 10.1007/s11948-014-9581-5