New Tools, New Focus on Neuroethics

Neuroscience is fun, fascinating and often intensely focused, either on furthering our understanding of how the nervous system works or on improving treatments for tragic neurological disorders. However, in our enthusiasm for the science, the ethical implications of our research often surface too late, and end up being clouded by controversy. The neuroscience community is now working to change this paradigm, exploring ways to integrate ethics early and explicitly throughout research.   

In 2014 NIH, DARPA, and NSF rolled out projects as part of The Brain Research through Advancing Innovative Technologies (BRAIN) Initiative. BRAIN investigators are working to develop much more powerful tools to interrogate and modulate neural circuits, from developing a census of cells in the brain to recording the firing of tens of thousands of neurons simultaneously to devices that might restore memory in patients with traumatic brain injury. It is anticipated that over time, BRAIN will considerably enhance our capabilities for monitoring and modulating brain activity in humans. Clearly this would have profound ethical implications that require a national, if not international, dialogue. Recently, the President asked the Presidential Commission on Bioethics to review the ethical issues associated with the conduct and implications of neuroscience research. Their report, Gray Matters: Integrative Approaches for Neuroscience, Ethics and Society, outlines many of the key areas for thought, dialog and planning. A major recommendation was that neuroethics be integrated into the actual planning and scientific activity of The BRAIN Initiative. In November, NIH followed up and convened a panel experienced in the ethics of neuroscience to discuss research questions central to the mission of the multiple NIH neuroscience Institutes and Centers as well as BRAIN. This NIH Neuroethics meeting (watch the videocast) brought together three dozen researchers, clinicians, bioethicists, and leadership from NSF, FDA, and NIH to discuss both the ethical conduct of neuroscience research and the ethical uses of applications stemming from that research.

The global neuroscience community at large is grappling with these same issues. In November, I spoke at the 2014 annual meeting of the International Neuroethics Society in a session on the ethical focus of The BRAIN Initiative and the Human Brain Project.

Not surprisingly, many of the questions surrounding research stemmed from current technologies, often thought to become more powerful and more widely used as they mature or are miniaturized. Today, techniques for brain activity mapping include EEG, MEG, fMRI or even polygraph testing. How do we disseminate the spread of new imaging technologies that might be able to parcel individuals into personality types, cognitive abilities, or predict their risk of developing cognitive decline/brain disorders with aging? Currently, techniques for direct brain circuit modulation are used widely for Parkinson’s disease patients undergoing deep brain stimulation (DBS). But normalization of brain circuits by DBS has also shown promise for the treatment of resistant depression. New techniques to control brain circuits might benefit many more patients with neurologic and psychiatric disorders, but raise questions of autonomy—who should control the devices that affect mood and the brain’s reward systems? The patient? The doctor? If a device is placed in the brain as part of a research study, what is the researcher’s responsibility for continued care of the patient and device? 

Questions about spinning off emerging therapeutic technologies into an industry focused on enhancing human brain function are even trickier. Techniques that monitor brain circuitry could provide feedback to guide rehabilitation therapy for optimal rewiring of brain circuits in patients with stroke. Could they also be used to enhance education of school children, athletic performance, and learning of other skills? These concerns are different from, but not totally foreign to, enhancement by pharmaceuticals, anabolic steroids, stimulants, growth hormones, etc.

Brain activity forms the physical basis of our humanity and neuroethics provides a framework for discussion of the ethical use of technologies that monitor or modulate the fundamental features that make each of us unique. Society has had a continuous dialog over the centuries about accepting, rejecting or regulating the tools that spring from science; that focus needs to sharpen on neuroscience as new tools open new windows into the brain.