Q&A: Neuroethics: A challenge for a new age: CrossCurrents Winter 2003/04
CrossCurrents
Hema Zbogar
This Q&A is based on a recent lecture given by Zach W. Hall at the Centre for Addiction and Mental Health in Toronto. Hall
is senior associate dean for research at the Keck School of Medicine at the University of Southern California.
What is neuroethics? How has our understanding of the brain raised ethical issues?
The bioethicist Al Jonsen has described neuroethics as "the unexplored continent lying between the two populated shores of
ethics and of neuroscience." With the principle established that our behaviour depends on our brains, which are shaped by
both genes and experience, the task for the future will be to understand the underlying mechanisms. Once we begin to understand
the mechanisms, we will have increasing power to intervene or to manipulate our brains. This offers tremendous hope for the
treatment of neurological and psychiatric disease. But it also has tremendous potential for misuse, which I see as the main
challenge for neuroethics.
What ethical and legal issues will arise from our ability to manipulate the brain?
One issue involves enhancement. As we develop more powerful ways to manipulate and enhance brain function, the possibility
arises of using them not simply to replace or restore functions lost through disease or damage, but rather to "improve" normal
functions. Suppose there is a way to change your basic capabilities or your personality or your "character"? A sort of "Botox"
treatment of the mind. It is not a large extension to imagine a day when pharmacologically resculpting of our personalities
may be possible, snipping out a bit of testiness here and adding a bit of humility there to achieve a desired temperament
or pleasing personality or more formidable intellect. Worse, one can imagine these services marketed commercially to relieve
invented pathologies.
But what's wrong with enhancement? First, there may be untoward effects of long-term use. Second, such treatments will only
be available to some, who will have an advantage. Finally, there is the argument that our brains are precious, and that to
tamper with them is not only a betrayal of our "essence," but hubris of the highest sort.
Neuroscience influences ideas of who we are. As we learn more about how the brain works, these discoveries will challenge
some of our fundamental notions of what it means to be human. We will find that much of our behaviour has its evolutionary
and mechanistic roots in animal behaviour. There is also the ancient question of free will and responsibility. But I believe
that neuroscience has little to contribute to this discussion. It will be decades or centuries before we have enough information
to begin to address this question. In the meantime, we cannot abandon the notion of responsibility for our actions.
As we learn more about our behaviours and their origins, we will learn more about the constraints on our behaviour and about
the sources of our individual differences. We will learn that small genetic differences between us create an interesting kaleidoscope
of personality and character traits. We know that some people are more athletic, religious, sexually promiscuous or "ethical"
than others. What will surprise us is the extent to which the latter are determined by genetics. The question is to what extent
will this information make us as a society more tolerant and understanding of our differences?
Finally, what responsibility do we have for our actions? If it is all determined by genetics, over which we have no control,
and by experience, over which we have limited control, what does moral or even legal responsibility mean? Is there room for
conscious choice and what does it mean? For the philosophers, the old question of free will and determinism raises its head
again. For the legal system, it's a question of "I'm not guilty, my brain made me do it." The real point is that we "feel"
as if we are free agents and we should assume and act as we are, even if we must acknowledge that that "feeling" itself may
be a hard-wired attribute of our nervous systems.
We have rules to govern behaviour so we may live together. A fundamental principle of our rule-making is that we must be responsible
and accountable for our actions. The legal question is whether a person is capable of knowing the rules and of making a choice
based on them. Neuroscience has little to say to the question of responsibility, since such responsibility is socially-defined,
based on moral and legal principles. The second question is one that in its extreme leaves us without a system of legal accountability,
which is unworkable, but in the shorter view has real subtleties and consequences. The question of when a person can be held
accountable is one in which the legal system and the medical system have not been able to accommodate.
How can neuroscientists and others deal most responsibly with these ethical issues?
We need to bear in mind two injunctions. The first is our need to engage as broad an audience as possible in these discussions.
Questions of what we should do are at their heart questions that depend deeply on our values. For answers, we need factual
knowledge, which neuroscientists can often provide, and we need clear thinking, which ethicists can often provide, but the
answers to how we should treat these issues must come from as broad a segment of our population as possible.
The second injunction is to beware the dangers of half knowledge. The brain is complicated, and although we will learn much
about it, there will also be much that we do not know. The popular pressures to jump to answers will often be powerful. One
of the most dangerous will be the idea that through brain science, we can understand, or worse, "predict" a person's character.
We will need to maintain our humility and our respect for the complexity of the brain, and thus for ourselves as human beings.
Centre for Addiction
