The Dana review examines ethical questions about the ends of research, enhancement, and human nature.

Are there ethical questions that ought to be raised about the ends of research? Are there ethical problems with enhancement versus treatment? And can we discover things about our nature, such as whether we have free will? These are three questions Dr. Donald Kennedy, editor in chief of Science magazine, identified as central to the field of neuroethics during his Dana Alliance Lecture on Neuroethics, titled “Neuroethics: An Uncertain Future.” Regulation of experimental processes is not a problem, Kennedy said in response to his first question. The gray area lies in research that might be put to bad use, but also could do a lot of good. As a university president, Kennedy said, he frequently rejected arguments that certain projects should be banned because they might be used for harmful purposes even though they also could provide benefits. Vetoing such research, he said, would be akin to prior restraint of free speech. Treatment versus enhancement raises another set of concerns, he said, as new ways of knowing the brain introduce new challenges and problems. “The technological speed of advance…is truly remarkable,” he said. Researchers understand the biochemistry of neural signaling much better, creating opportunity for improvements in drugs for mood disorders and intervention in learning and memory. For Kennedy, enhancement from a neuroscience perspective has social implications but is not a question of human nature. “If by taking the right drug some persons can improve their position, questions should arise about whether the playing field is level—especially if the treatment is expensive and not available to some competitors,”Kennedy said. But, he added, “I find a kind of naïve nativism in the view that there’s a natural state that we are somehow messing with.” Enhancement is not a futuristic ethical issue, either, Kennedy said. Drugs are helping patients who have Attention Deficit Hyperactivity Disorder, but people who have not been diagnosed with ADHD are using it for enhancement, and concerns are stirring about prescribing drugs for the latter group. Similar questions arise in the areas of learning and memory function. Kennedy also had a different twist on enhancement: the idea that there may be thoughtful objections to certain treatments, such as cochlear implants for deaf children. “In a number of cases, deaf parents have said that they do not wish their deaf child to receive an enhancement of that kind,” he said. “They have their reasons. The family has built an effective communication network based on shared capacities and limitations, and may have already invested heavily in building that network. “On the other hand, one might argue that families don’t, after all, stay together forever, and that the child needs to be equipped to deal effectively with hearing adults.” Kennedy, who did not propose a solution, said he mentioned the example to highlight the complexity of such neuroethical questions. Privacy In timely fashion, a piece in the Oct. 26 New York Times Magazine drew attention to the use of brain imaging for economic purposes. Kennedy discussed two applications: responses to advertisements in different media and an exercise in which subjects’ neural responses are measured when they make economic choices. Kennedy said he does not believe these applications introduce major ethical questions, but he is concerned that similar practices could take root in politics: How will we feel when the next candidate for governor—of California, say—has been selected through the use of consumer-preference videos?” Using a hypothetical case as an example, Kennedy also discussed the boundaries of functional magnetic resonance imaging (fMRI) and how it might one day be used to classify people for behavioral risk. He is concerned, he said, with “knowledge we should do without.” “Through some future fMRI technology, it just might be possible to derive for an individual—just to take a few examples—a predictive moral choice profile, an executive skill assessment, and an estimate of the capacity to repress or retrieve old memories,” Kennedy said. “Perhaps worse, it might generate a capacity to peer into intentions, or value systems, or behavioral predilections of various kinds.” Thus, Kennedy said, privacy becomes a central issue in neuroethics. “I don’t want a record of how my brain works trailing after me,” he said. Free Will Kennedy closed his lecture with a discussion of the impact of increasing knowledge on our sense of ourselves. “The more we know, does the will seem less free?” he asked. Kennedy left the philosophical argument to others, saying only that our brains are complex enough that he does not see a threat to free will or our individual decisions. But he raised one final question: What will happen if we come to see more similarities between the brains of humans and animals than we see differences? Kennedy is not concerned. “I find great inspiration in the unity of nature,” Kennedy said. “Anything that draws our species into a closer relationship with the rest of life strikes me as a gain in wisdom.” Several members of the audience approached Kennedy after his speech with additional neuroethical questions. Kennedy tackled some of them, then acknowledged that they were truly difficult. The important thing is to develop apersonal sense of what is acceptable and what is not, Kennedy said.

ethics, neuroethics, bioethics, research, enhancement, treatment, dana, foundation