Advancing ethical neuroscience

EDITORIAL Advancing Ethical Neuroscience “A s humans, we can identify galaxies light years away, we can study particles smaller than an atom. But we still haven’t unlocked the mystery of the three pounds of matter that sits between our ears.” 1 The time is ripe, remarked President Obama during his 2013 announcement of the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, to mount a focused effort to study the human brain’s 100 billion neurons and their connections. It is certain that neuroscience research funded through the BRAIN Initia- tive, and other sources, will advance our understanding of the brain and is also likely to lead to new treatments for incurable and costly health problems including Alz- heimer disease, Parkinson disease, traumatic brain injury, blindness and other sensory disorders, schizophrenia, depression, post-traumatic stress disorder, and chronic pain, among many other disabling neurological and psy- chiatric conditions. President Obama asked the Presidential Commis- sion for the Study of Bioethical Issues (Bioethics Com- mission), of which I am a member, to consider the ethical implications of neuroscience research in a broad context and also to focus specifically on its applications in conjunction with the BRAIN Initiative. The Bioethics Commission is an independent, deliberative panel of experts that advises the President and the Administration, and in so doing educates the nation on bioethical issues. The Bioethics Commission has released a series of reports, including reports on the ethical considerations of emerging science and technologies like synthetic biology, whole genome sequencing, and neuroscience. Other reports addressed human subject protections, including current and historical regulations and practices, ethical considerations of pediatric research, and research in the context of a public health emergency such as the western African Ebola epidemic. This article provides a review of the ethical issues associated with the conduct and implications of neuro- science research. Every neuroscientist understands that to maximize the benefits of neuroscience research to indi- viduals and society we must ensure that the science pro- gresses ethically. However, to do this successfully will require a flexible, nuanced approach, guided by basic principles. We should develop, for example, a proactive strategy to deal with issues about which reasonable peo- ple will disagree, and to plan for the “known unknowns” that are certain to arise. Another key need is to avoid exaggeration and overstatement (“neurohype”) when communicating new findings. Even statements that are technically correct but presented in an overly optimistic or far-reaching manner in terms of health implications can easily be misinterpreted by the general public, lead- ing to unfounded conclusions and ultimately an erosion of the public trust in science and medicine. The tend- ency to overestimate the significance of an advance is particularly germane to contemporary neuroscience, which often relies on and creates impressive new technologies. The Bioethics Commission responded to the Presi- dent’s charge in a 2-volume report, the first of which, Gray Matters: Integrative Approaches for Neuroscience, Ethics, and Society, was released in May 2014 and called for the active and iterative integration of ethics early and throughout scientific research. At the time of its release, I was pleased to author, in these pages and on behalf of the Bioethics Commission, a perspective on this first vol- ume. 2 In its second and final volume, Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Soci- ety, the Bioethics Commission now addresses 3 topics that capture public and scholarly attention to explore ethical tensions and societal implications of advances in neuroscience. Through its report, the Bioethics Commis- sion sought to clarify misperceptions and clear an ethical path forward for the field. Cognitive Enhancement and Beyond The Bioethics Commission expanded the cognitive enhancement conversation to include all neural modi- fiers, or any methods, behaviors, conditions, or interven- tions that alter the brain and nervous system. The Bioethics Commission believes that there is nothing inherently unethical about enhancement of human nerv- ous system capabilities, including cognitive enhancement. Several neural modification techniques, such as good nutrition, exercise, and education, promote brain and nervous system function and are widely considered ethi- cally permissible and desirable. Drugs such as methylphe- nidate, dextroamphetamine, modafinil, and cholinesterase inhibitors might have some possible, but quite modest, cognitive enhancement effects in healthy people. How- ever, the use of some neural modification techniques might pose ethical concerns. Although most currently available neural modification approaches offer only incre- mental benefits, and some such as deep brain stimulation C 2015 American Neurological Association V