[wordup] Open your mind: The ethics of brain science

[Adam Shand]

Coming from a Science Fiction obsessed childhood it took a long time for
me to see the rampant use of technology as a potentially bad thing. 
Whether that was because I was naive or because I had the lust for the 
adventure and chaos that always ensued ("Schismatrix "by Bruce Sterling
or "Snow Crash" by Neal Stephenson are perfect examples) I don't know.

Regardless, it's good that people are thinking and talking about what
the hell all this ability to "do stuff" means.

Adam.


From: http://www.economist.com/opinion/displaystory.cfm?story_id=1143317

Open your mind
May 23rd 2002
>From The Economist print edition

Genetics may yet threaten privacy, kill autonomy, make society
homogeneous and gut the concept of human nature. But neuroscience could
do all of these things first

IN THE genetically engineered world portrayed in “Gattaca”, a movie made
in 1997, the hero and heroine attend a concert in which a pianist
performs a concerto that can be played only by a person with six fingers
on each hand. This is a society in which genetic perfectionists have had
their way. The concert-goers have been altered before birth to be free
of such ailments as baldness, obesity and diabetes, and to be tall,
good-looking and intelligent. In that room, improbable as it may seem,
only Ethan Hawke has lived a life free of genetic enhancement; he alone
has had to take his chances with the genetic lottery of natural
conception.

Compare this scene to one in which the effects of neurotechnology
(technology that makes it possible to manipulate the brain) are
pervasive. The old man on the left of the aisle is being saved from
Alzheimer's disease by an implant that bathes his brain cells in a
healthy broth of chemicals. The little girl in the circle, vows her
doctor, has a cortex that will one day win her a Nobel prize in
physics—if she keeps up the correct regime of “cogniceuticals”, of
course. As a condition of their employment, the security guards posted
at the entrance had to undergo brain scans to demonstrate that they were
free of propensities to uncontrollable rage. The musicians on stage are
on drugs that speed their reflexes, heighten their hearing and assuage
their performance anxiety. Not that different from “Gattaca”, is it?

The mind's eye

Although often overlooked, advances in neurotechnology raise ethical and
legal questions of the same nature and gravity as advances in genetics.
Concerns about genetic technology fall into three main categories:
first, how much screening should be allowed for certain genetic traits;
second, who should have access to such information; and third, what will
happen when those traits can be modified at will, possibly in ways that
challenge the very idea of what it is to be human. 

Concerns about neurotechnology fall into the same three groups.
Neuroscientists may soon be able to screen people's brains to assess
their mental health; to distribute that information, possibly
accidentally, to employers or insurers; and to “fix” faulty personality
traits with drugs or implants on demand. They may also, according to
some philosophers, expose fallacies in philosophical thinking that go to
the heart of human nature by showing how the brain actually makes
decisions.

Until recently, neurobiologists have been constrained in their research
by the consideration that most kinds of experiment with the human brain
are seen as unethical. Tradition has it that they must sit around with
their fingers crossed, hoping that a patient will walk through the door
sporting a tumour or other injury in a part of the brain whose function
is not yet understood. Ideally, this patient will show some odd
behaviour—say, being able to multiply but not add, or mistreating cats
but not dogs—that can be tied to the injured area. Thus, painstakingly,
a map of which parts of the brain do what can be built up.

Over the past decade, however, machines for measuring brain activity
have proliferated. There are now half a dozen such technologies, ranging
from old favourites, such as electro-encephalography, to new-fangled
methods including magneto-encephalography, which measures the brain's
magnetic fields, and single-photon-emission computerised tomography,
which tracks radioactively tagged chemicals around the organ. One of the
most important new techniques is functional magnetic-resonance imaging
(fMRI), which employs powerful magnetic fields to monitor the rate of
blood flow in the brain, and thus to determine which parts are
particularly active.

With the help of fMRI, researchers can observe which brain areas are
involved when somebody performs a particular task or thinks along
particular lines. That could be a boon. It could, for example, identify
children whose brains are not maturing normally—making possible early
intervention with, say, special lessons. 

A study to be published shortly in Neuroimage shows how this might work.
Vinod Menon and his colleagues at Stanford University have been using
fMRI to investigate how people's brains behave when they are subjected
to the Stroop colour-word interference task. The Stroop task is a
well-established psychological test that presents subjects with the
names of colours printed in ink that does not match the colour named.
The subjects have to name the colour of the ink, not the word that has
been printed.

As people mature, their brains get better at coping with the challenge
the task poses. Dr Menon has found that children, adolescents and adults
show progressively different patterns of brain activity which appear to
reflect this improvement. He has discovered that a child whose brain is
not maturing normally will show an unusual pattern of brain activation
when performing the test. That reveals problems with brain development
that an ordinary questionnaire-based psychological evaluation does not.

Nobody could object to such a worthy enterprise. But what about the
following idea? Greg Siegle and his colleagues at the University of
Pittsburgh are studying depression. In a paper published in this month's
issue of Biological Psychiatry, they report that when depressed
individuals are read a list of depressing words, they show a different
response in a region of the brain called the amygdala from that
displayed by “normal” individuals. The amygdalas of the depressed hum
away for as long as 25 seconds after hearing a depressing word. Those of
individuals who have never been depressed stop showing activity after
ten seconds. Dr Siegle suggests that the depressed subjects ruminate on,
or think repeatedly about, sad words, while the undepressed subjects
simply move on.

Since the amygdala is known to be involved in processing emotion, that
is not altogether startling. Suppose, though, that job-recruiting
agencies were fitted with fMRI machines (unlikely at the moment, given
their expense, but not unimaginable). An individual who wished to
conceal evidence of depression from possible employers would have a much
harder time doing so in the face of fMRI, than in the face of a little
light form-filling. 

And that may only be the start. Just as genetic markers can be
associated with physical states, so features of brain scans will surely
be linked to a wide variety of mental states. fMRI screening might, for
example, become a foolproof method of lie detection—one that could catch
out even “astute liars” who pretend to have impaired memories when put
under pressure by an interrogator. Other personality traits, such as
tendencies to aggression or risk-aversion, could also yield their
secrets to fMRI's probing glance.

Steal your face

Medical privacy is another area that brain scanning could compromise.
One of the most immediate threats is a little-considered side-effect of
the scanning process: that what is scanned and recorded is actually the
head, and not merely the brain. In other words, a magnetic scan of a
brain also contains enough information about the front of the skull to
recreate a recognisable depiction of the scanned subject. The result is
that, unlike a genetic profile, which does not, by itself, tell you who
has been profiled, no magnetic-resonance image is inherently anonymous.

Neuroscientists are already building up databases of brain scans for
research purposes. In 2000 John Van Horn and Michael Gazzaniga, two
cognitive neuroscientists at Dartmouth College in Hanover, New
Hampshire, launched a database called the fMRI Data Centre, to help
disseminate fMRI studies among scientists. They hope that it will spur
discoveries in neuroscience in the same way that GenBank, a public
database of gene sequences, has spurred discoveries in genetics. The
fMRI Data Centre makes raw data from such studies available to
researchers, and will soon organise the data so that interesting
features can be extracted from it systematically. So far, says Dr
Gazzaniga, roughly 400 researchers around the world have requested data
from the centre. Those data are shipped to them on compact discs to do
with as they please.

One answer to the lack of anonymity of magnetic-resonance images is to
scramble the picture in the part of the image that contains facial
information. The managers of the Dartmouth database do just that. Such
scrambling, however, makes the data useless for some sorts of analysis.
It is therefore questionable whether the operators of other databases of
neuro-images (several are planned) will follow suit.

Pictures of perfection

Just as with genetics, however, the spectre that most terrifies many of
those who fear the advance of neurotechnology is that it will one day be
capable of “enhancing” human beings. Some worry that this may blunt the
differences between individuals, turning society into one homogeneous
mass. Others see the opposite risk—a Gattacesque division between the
privileged and the unenhanced.

Potential dystopias always make good press. But drawing the line between
necessary therapy and discretionary enhancement is genuinely difficult.
Some argue that society accepted the idea of so-called “cosmetic
psychopharmacology” when people first began using recreational drugs.
Who has not perceived himself to be wittier and more attractive than
normal when under the influence of alcohol—or, indeed, seen wit and
attractiveness in others in the same circumstances?

Another argument is that drugs for the brain are simply one more step
down a road taken by orthodontics, face lifts, Viagra and other medical
extras. That may be so. But it could be a step in seven-league boots,
for pharmaceutical companies are only just beginning to mine the
spectrum of psychological ailments that flesh is heir to. Drugs to
combat shyness, forgetfulness, sleepiness and stress are now in or close
to clinical trials, not to mention better versions of drugs that have
already swept society—what Arthur Caplan, a bioethicist at the
University of Pennsylvania, calls “super-Prozacs”.

One example of the trend towards making the normal treatable is research
into “mild cognitive impairment”, the kind of slight deterioration in
memory that goes with getting old. Or that does for now, anyway. Many
companies are hunting for drugs to fend off this sort of memory loss.
Researchers at Cortex Pharmaceuticals in Irvine, California, for
example, are exploring molecules known as ampakines. These attach
themselves to nerve-cell proteins called AMPA receptors. That serves to
amplify the transmission of signals from one nerve cell to another. In
particular, it amplifies the effect of a second protein, the NMDA
receptor, which is known to be associated with learning. Meanwhile,
Targacept, a firm based in Winston-Salem, North Carolina, is looking at
another group of nerve-cell proteins, the nicotinergic receptors, whose
activation has been shown to increase alertness and may fend off
cognitive decline.

Another technology, known as transcranial magnetic stimulation (TMS),
also holds out the promise of enhancement. Since nerve cells use
electrical signals, and magnetic fields can induce and disrupt such
signals, a strong, well-aimed magnetic stimulation can affect the
brain's operation. By holding a magnetic coil over somebody's skull, a
researcher can affect the activity of the piece of cortex beneath, while
causing no pain to the subject. Sending repeated magnetic pulses
disrupts neural transmission in that area, in effect creating a small
lesion on demand. Although nobody is quite sure how it works, there is
evidence to suggest that certain kinds of TMS improve performance in
memory and reasoning tasks.

The death of free will?

Screening, privacy and enhancement are all important issues, to be sure.
For many critics, though, they are side-shows. The really uncomfortable
questions raised by brain science are those that go to the heart of what
it is to be human. Or, more specifically, what philosophers and
theologians have claimed is the heart of what it is to be human.

In the West, at least, that defining quality is the concept of “free
will”. Although some philosophers see free will as an illusion that
helps people to interact with one another, others think it is genuine—in
other words, that an individual faced with a particular set of
circumstances really could take any one of a range of actions. That,
however, sits uncomfortably with the idea that mental decisions are
purely the consequence of electrochemical interactions in the brain,
since the output of such interactions might be expected to be an
inevitable consequence of the input. It also sits uncomfortably with the
separate, but parallel, argument that correct moral choices are the
result of a sort of biological decision-making programme, shaped by
evolution, rather than being arrived at by abstract reasoning.

Whatever the philosophical arcana of the field, there are already cases
where neurotechnology may have a practical effect on people's moral
development. Erik Parens of the Hastings Centre, a think-tank in
Garrison, New York, is concerned that it could, for example, “reduce the
number of ways acceptable to be a person”.

To illustrate this point he says that the act of giving a normal,
healthy child Ritalin, a drug used to treat so-called hyperactivity, is
really “a substantive moral choice”, because it tells that child that he
needs to change to be acceptable. If forgetfulness, xenophobia and a
whole host of the other eccentricities that make up a person's character
become optional traits rather than inevitable ones, people will be more
inclined to discriminate against the bearers of those traits.

Discoveries in neuroscience may also have profound legal implications.
Most courts, for example, accept a claim of insanity as a defence in
certain criminal cases. If a propensity towards aggression or violence
is shown to have a biological basis in the brain, a lawyer may argue
that his client could not control his violent urges. Courts may be asked
to treat brain-image data as exculpatory evidence, which shows that a
suspect is not really guilty of a crime he has committed.

Donald Kennedy, a neuroscientist who is also editor of Science, says it
is likely that “some extension of the domain of exculpatory conditions”
will be made as a result of neuroscientific advances. In any case, each
jurisdiction treats insanity claims in its own way, so they may well
disagree over whether brain-image data are exculpatory. In Texas, for
example, all that a prosecutor needs to demonstrate is that a suspect
knew “the difference between right and wrong” at the time of the crime.
Even individuals who are clearly insane can be found guilty if they meet
this test.

Soul-searching questions

In many ways, therefore, thinkers who are wrestling with questions of
free will, the soul and human nature are seeing the terms of their
debate altered by modern brain science. But the history of the debate
may offer consolation to those who fear that neurotechnology is a hair's
breadth from catapulting society into a “post-human future”, as Francis
Fukuyama termed it in the title of a recent book. The human soul—or its
physiological equivalent—has proved surprisingly elusive.

René Descartes was a philosopher who believed that he had found the
exact point in the brain where the body and soul meet. Rather
unromantically, the structure he chose was the humble pineal gland. As
the author of a popular textbook on the subject dryly notes, however,
“this now seems unlikely because pineal tumours do not cause the changes
one would expect to find associated with distortion of the soul.” There
is a deal of searching to do yet before human nature gives up its
secrets.