Ethical debates over the use of mental health knowledge and practice at the Guantánamo Bay detention facility have mostly revolved around military clinicians sharing detainee medical information with interrogators, falsifying death certificates in interrogations, and disagreements over whether the Central Intelligence Agency’s “enhanced interrogation techniques” violated bioethical principles to do no harm. However, debates over the use of magnetic resonance imaging in the mental health evaluations of detainees have received little attention. This paper provides the first known analysis of such (...) debates over MRI use in the case of Abd al-Rahim al- Nashiri. Through a close reading of open-source legal documents such as defense motions, prosecution motions, judge rulings, and al-Nashiri’s mental health evaluation, debates over MRI use become interpretive contests over the very meanings of mental illness and the extent to which MRI results can verify whether he was tortured in CIA custody. Such work can revitalize interest in the neuroethics of national security. (shrink)

Neuroenhancement involves the use of neurotechnologies to improve cognitive, affective or behavioural functioning, where these are not judged to be clinically impaired. Questions about enhancement have become one of the key topics of neuroethics over the past decade. The current study draws on in-depth public engagement activities in ten European countries giving a bottom-up perspective on the ethics and desirability of enhancement. This informed the design of an online contrastive vignette experiment that was administered to representative samples of 1000 respondents (...) in the ten countries and the United States. The experiment investigated how the gender of the protagonist, his or her level of performance, the efficacy of the enhancer and the mode of enhancement affected support for neuroenhancement in both educational and employment contexts. Of these, higher efficacy and lower performance were found to increase willingness to support enhancement. A series of commonly articulated claims about the individual and societal dimensions of neuroenhancement were derived from the public engagement activities. Underlying these claims, multivariate analysis identified two social values. The Societal/Protective highlights counter normative consequences and opposes the use enhancers. The Individual/Proactionary highlights opportunities and supports use. For most respondents these values are not mutually exclusive. This suggests that for many neuroenhancement is viewed simultaneously as a source of both promise and concern. (shrink)

Given dramatic increases in recent decades in the pace of scientific discovery and understanding of the functional organization of the brain, it is increasingly clear that engagement with the neuroscientific literature and research is central to making progress on philosophical questions regarding the nature and scope of human freedom and responsibility. While patterns of brain activity cannot provide the whole story, developing a deeper and more precise understanding of how brain activity is related to human choice and conduct is crucial (...) to the development of realistic, just, and intellectually rigorous models of human agency and moral responsibility. In this special issue, we acknowledge that “free will” and “moral responsibility” are not concepts with which neuroscience can directly engage, and instead focus on self-governance, and the capacities that contribute to self-governance, which are more tractable for scientific investigation and are prerequisites for the presence of moral responsibility. (shrink)

Although dual-process or divided-mind models of self-control dominate the literature, they suffer from empirical and conceptual challenges. We propose an alternative approach, suggesting that self-control can be characterized by a fragmented part versus integrated whole dynamic. Whereas responses to events derived from fragmented parts of the mind undermine self-control, responses to events derived from integrated wholes enhance self-control. We review empirical evidence from psychology and related disciplines that support this model. We, moreover, discuss the implications of this work for psychology, (...) neuroscience, economics, and philosophy. In particular, we highlight how this model addresses many of the conceptual and empirical short-comings of divided-mind models. We suggest that understanding self-control as the interplay between fragmented parts versus integrated wholes, moreover, provides novel insights and testable new hypotheses. (shrink)

Moral judgment has typically been characterized as a conflict between emotion and reason. In recent years, a central concern has been determining which process is the chief contributor to moral behavior. While classic moral theorists claimed that moral evaluations stem from consciously controlled cognitive processes, recent research indicates that affective processes may be driving moral behavior. Here, we propose a new way of thinking about emotion within the context of moral judgment, one in which affect is generated and transformed by (...) both automatic and controlled processes, and moral evaluations are shifted accordingly. We begin with a review of how existing theories in psychology and neuroscience address the interaction between emotion and cognition, and how these theories may inform the study of moral judgment. We then describe how brain regions involved in both affective processing and moral judgment overlap and may make distinct contributions to the moral evaluation process. Finally, we discuss how this way of thinking about emotion can be reconciled with current theories in moral psychology before mapping out future directions in the study of moral behavior. (shrink)

Given the ubiquity and centrality of social and relational influences to the human experience, our conception of self-governance must adequately account for these external influences. The inclusion of socio-historical, externalist considerations into more traditional internalist accounts of autonomy has been an important feature of the debate over personal autonomy in recent years. But the relevant socio-temporal dynamics of autonomy are not only historical in nature. There are also important, and under-examined, future-oriented questions about how we retain autonomy while incorporating new (...) values into the existing set that guides our interaction with the world. In this paper, we examine these questions from two complementary perspectives: philosophy and neuroscience. After contextualizing the philosophical debate, we show the importance to theories of autonomous agency of the capacity to appropriately adapt our values and beliefs, in light of relevant experiences and evidence, to changing circumstances. We present a plausible philosophical account of this process, which we claim is generally applicable to theories about the nature of autonomy, both internalist and externalist alike. We then evaluate this account by providing a model for how the incorporation of values might occur in the brain; one that is inspired by recent theoretical and empirical advances in our understanding of the neural processes by which our beliefs are updated by new information. Finally, we synthesize these two perspectives and discuss how the neurobiology might inform the philosophical discussion. (shrink)

Neuroscience has illuminated the neural basis of decision-making, providing evidence that supports specific models of decision-processes. These models typically are quite mechanical, the realization of abstract mathematical “diffusion to bound” models. While effective decision-making seems to be essential for sophisticated behavior, central to an account of freedom, and a necessary characteristic of self-governing systems, it is not clear how the simple models neuroscience inspires can underlie the notion of self-governance. Drawing from both philosophy and neuroscience I explore ways in which (...) the proposed decision-making architectures can play a role in systems that can reasonably be thought of as “self-governing”. (shrink)

To make behavioral choices that are in line with our goals and our moral beliefs, we need to gather and consider information about our current situation. Most information present in our environment is not relevant to the choices we need or would want to make and thus could interfere with our ability to behave in ways that reflect our underlying values. Certain sources of information could even lead us to make choices we later regret, and thus it would be beneficial (...) to be able to ignore that information. Our ability to exert successful self-governance depends on our ability to attend to sources of information that we deem important to our decision-making processes. We generally assume that, at any moment, we have the ability to choose what we pay attention to. However, recent research indicates that what we pay attention to is influenced by our prior experiences, including reward history and past successes and failures, even when we are not aware of this history. Even momentary distractions can cause us to miss or discount information that should have a greater influence on our decisions given our values. Such biases in attention thus raise questions about the degree to which the choices that we make may be poorly informed and not truly reflect our ability to otherwise exert self-governance. (shrink)

Many find it intuitive that those who use enhancements like steroids and Adderall in Olympic weightlifting and education are due less praise than those who perform equally well without using these enhancements. Nonetheless, it is not easy to coherently explain why one might be justifiably due less praise for using these technologies to enhance one’s performance. Justifications for this intuition which rely on concerns regarding authenticity, cheating, or shifts in who is responsible for the performance face serious problems. Santoni de (...) Sio et al., however, have recently defended a justification for this intuition which avoids the problems competing justifications face; the nature-of-activities justification. This justification relies on a conceptual analysis of the nature of activities and does not require the defense of any particular ethical stance concerning the use of enhancements. Santoni de Sio et al. claim that the success of the nature-of-activities account requires distinguishing between practice-oriented activities and goal-directed activities. I, however, show that this distinction is both deeply problematic and unnecessary. After exposing the weaknesses of Santoni de Sio et al.’s original account, I defend a simpler and less problematic version of the nature-of-activities account. The revised account is capable of both justifying this intuition of less praise and allowing one to determine when enhancements should be deemed permissible, impermissible, or obligatory for a given activity. (shrink)

It has recently been suggested that delusions be conceived of as symptoms on the harmful dysfunction account of disorder: delusions sometimes arise from dysfunction, but can also arise through normal cognition. Much attention has thus been payed to the question of how we can determine whether a delusion arises from dysfunction as opposed to normal cognition. In this paper, we consider another question, one that remains under-explored: which delusions warrant treatment? On the harmful dysfunction account, this question dissociates from the (...) question about dysfunction—there are a broad range of “treatable conditions” beyond mere harmful dysfunctions. As such, many conditions that arise from normal cognition are also eligible for medical intervention. We argue that some delusions that arise from normal cognition may well fall under the banner of treatable conditions. We examine the practical and ethical questions surrounding such treatment, including the issue of coercive and deceptive treatment options. (shrink)

This paper discusses J.S. Mill’s distinction between higher and lower pleasures, and suggests that recent neuroscientific evidence counts against it.

Despite growing evidence that a significant number of patients living with Parkison’s disease experience neuropsychiatric changes following Deep Brain Stimulation treatment, the phenomenon remains poorly understood and largely unexplored in the literature. To shed new light on this phenomenon, we used qualitative methods grounded in phenomenology to conduct in-depth, semi-structured interviews with 17 patients living with Parkinson’s Disease who had undergone DBS. Our study found that patients appear to experience postoperative DBS-induced changes in the form of self-estrangement. Using the insights (...) from patients’ subjective perceptions of postoperative self-change provides a potent explanation of potential DBS-induced self-estrangement. (shrink)

This paper critically discusses the argument from objectification – as recently presented by Elizabeth Shaw – against mandatory direct brain interventions targeting criminal offenders’ values as part of rehabilitative or reformative schemes. Shaw contends that such DBIs would objectify offenders because a DBI “excludes offenders by portraying them as a group to whom we need not listen” and “implies that offenders are radically defective with regard to one of the most fundamental aspects of their agency”. To ensure that offenders are (...) not objectified, Shaw first maintains that we should restrict rehabilitative/reformative schemes to attempts at rational dialogue because such an approach respects the offender’s personhood. Second, Shaw claims that we should not portray offenders as radically defective because such treatment would only negatively impact offenders’ already tenuous relationship with society. Third, Shaw contends that we should not confer the state the power to change an offender’s values because the state lacks insight into what constitutes the right values. I contend that none of these arguments should prevent the use of value-targeting DBIs. First, I show that the dialogue requirement for rehabilitative schemes is insufficient ground from which to oppose the use of these DBIs. Second, I show that it is doubtful that the use of DBIs as proposed would damage the relationship between offenders and society. Finally, although the state may often lack insight into what constitutes the correct values, this lack of insight should not by itself prevent value-targeting DBIs from being employed on certain groups of offenders. (shrink)

According to the dual-process account of moral judgment, deontological and utilitarian judgments stem from two different cognitive systems. Deontological judgments are effortless, intuitive and emotion-driven, whereas utilitarian judgments are effortful, reasoned and dispassionate. The most notable evidence for dual-process theory comes from neuroimaging studies by Joshua Greene and colleagues. Greene has suggested that these empirical findings undermine deontology and support utilitarianism. It has been pointed out, however, that the most promising interpretation of his argument does not make use of the (...) empirical findings. In this paper, I engage with recent attempts by Greene to vindicate the moral significance of dual-process theory and the supporting neuroscientific findings. I consider their potential moral significance with regard to three aspects of Greene’s case against deontology: the argument from morally irrelevant factors, the functionalist argument and the argument from confabulation. I conclude that Greene fails to demonstrate how neuroscience and dual-process theory in general can advance moral theorizing. (shrink)

Should the development of pharmacological cognitive enhancers raise worries about doping in cognitively demanding activities? In this paper, we argue against using current evidence relating to enhancement to justify a ban on cognitive enhancers using the example of chess. It is a mistake to assume that enhanced cognitive functioning on psychometric testing is transferable to chess performance because cognitive expertise is highly complex and in large part not merely a function of the sum specific sub-processes. A deeper reason to doubt (...) that pharmacological cognitive enhancers would be as significant in mind sports is the misleading parallel with physical enhancement. We will make the case that cognitive performance is less mechanical in nature than physical performance. We draw lessons from this case example of chess for the regulation of cognitive enhancement more generally in education and the professions. Premature regulation runs the risk of creating a detrimental culture of suspicion that ascribes unwarranted blame. (shrink)

In a recent article, Sabine Müller, Merlin Bittlinger, and Henrik Walter launch a sweeping attack against what they call the "personal identity debate" as it relates to patients treated with deep brain stimulation (DBS). In this critique offered by Müller et al., the so-called personal identity debate is said to: (a) be metaphysical in a problematic way, (b) constitute a threat to patients, and (c) use "vague" and "contradictory" statements from patients and their families as direct evidence for metaphysical theories. (...) In this response, I critically evaluate Müller et al.'s argument, with a special focus on these three just-mentioned aspects of their discussion. My conclusion is that Müller et al.'s overall argument is problematic. It overgeneralizes criticisms that may apply to some, but certainly not to all, contributions to what they call the personal identity-debate. Moreover, it rests on a problematic conception of what much of this debate is about. Nor is Müller et al.'s overall argument fair in its assessment of the methodology used by most participants in the debate. For these reasons, we should be skeptical of Müller et al.'s claim that the "personal identity debate" is a "threat to neurosurgical patients". (shrink)

This is a reply to Jesse Prinz and Paul Bloom’s skepticism about the moral importance of empathy. It concedes that empathy is spontaneously biased to individuals who are spatio-temporally close, as well as discriminatory in other ways, and incapable of accommodating large numbers of individuals. But it is argued that we could partly correct these shortcomings of empathy by a guidance of reason because empathy for others consists in imagining what they feel, and, importantly, such acts of imagination can be (...) voluntary – and, thus, under the influence of reflection – as well as automatic. Since empathizing with others motivates concern for their welfare, a reflectively justified empathy will lead to a likewise justified altruistic concern. In addition, we argue that such concern supports another central moral attitude, namely a sense of justice or fairness. (shrink)

Women are diagnosed with clinical depression at twice the rates as men. Treating depression through psychotherapy or medication both focus on changing an individual, rather than addressing socioecological influences or social roles. In the current study, participants read of systemic inequality contributing to differential rates of depression in either American men or women, or in two fictitious Australian First Nation groups. Participants then considered the acceptability and efficacy of treating depression through psychotherapy, medication, or social change. When socioecological inequities and (...) unequal social roles were presented through an unfamiliar foreign lens, participants were more likely to recognize the systemic unfairness, and endorsed social change more than psychotherapy or medication as a treatment strategy. However, when identical social inequities and social roles were presented through descriptions of American men and women, social intervention was less likely to be endorsed, and psychotherapy or medication gained in acceptability. Participants of color were also more likely to recognize and endorse social change as a strategy for treating depression, while those reporting a history of psychotropic medication for affective disorders rated medication as more effective and acceptable. (shrink)

IntroductionTourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered.Methods and ResultsWe discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he experienced a tic reduction of (...) more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects.DiscussionSpecific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication.ConclusionClinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

IntroductionTourette Syndrome is a childhood onset disorder characterized by vocal and motor tics and often remits spontaneously during adolescence. For treatment refractory patients, Deep Brain Stimulation may be considered.Methods and ResultsWe discuss ethical problems encountered in two adolescent TS patients treated with DBS and systematically review the literature on the topic. Following surgery one patient experienced side effects without sufficient therapeutic effects and the stimulator was turned off. After a second series of behavioural treatment, he experienced a tic reduction of (...) more than 50%. The second patient went through a period of behavioural disturbances that interfered with optimal programming, but eventually experienced a 70% tic reduction. Sixteen DBS surgeries in adolescent TS patients have been reported, none of which pays attention to ethical aspects.DiscussionSpecific ethical issues arise in adolescent TS patients undergoing DBS relating both to clinical practice as well as to research. Attention should be paid to selecting patients fairly, thorough examination and weighing of risks and benefits, protecting the health of children and adolescents receiving DBS, special issues concerning patient’s autonomy, and the normative impact of quality of life. In research, registration of all TS cases in a central database covering a range of standardized information will facilitate further development of DBS for this indication.ConclusionClinical practice should be accompanied by ongoing ethical reflection, preferably covering not only theoretical thought but providing also insights in the views and perspectives of those concerned, that is patients, family members and professionals. (shrink)

We argue that many modern marketing techniques are morally problematic because they take advantage of a phenomenon known as ‘ego-depletion’ according to which willpower is, similar to physical strength, a limited resource that can be depleted by predictable factors. We argue that this is impermissible for the same reason that spiking someone’s drink to impair their judgment is impermissible.

David Shoemaker has claimed that a binary approach to moral responsibility leaves out something important, namely instances of marginal agency, cases where agents seem to be eligible for some responsibility responses but not others. In this paper we endorse and extend Shoemaker’s approach by presenting and discussing one more case of marginal agency not yet covered by Shoemaker or in the other literature on moral responsibility. Our case is that of Kenneth Parks, a Canadian man who drove a long way (...) to his mother-in-law’s and killed her in a state of somnambulism. We support our claim about Parks’ marginal responsibility in three steps: we first deny that Parks acts involuntarily as traditionally claimed in the legal literature; we then propose to extend Shoemaker’s analysis of marginal responsibility based on quality of will so as to include two other dimensions: the moral status of the agent and the actual causal effects of their actions; finally, we distinguish Parks’ marginal responsibility from four other existing concepts: “tracing”, diminished responsibility, causal responsibility, and moral disapproval without responsibility. (shrink)

There might be value in examining the phenomenon of free will, without attempting to solve the debate surrounding its existence. Studies have suggested that diminishing belief in free will increases cheating behavior and that basic physiological states such as appetite diminish free will. These findings, if robust, could have important philosophical and ethical implications. Accordingly, we aimed to critically review methodologies and results in the body of literature that speaks to the two following questions: whether certain factors can change belief (...) in free will or not and whether changes in belief in free will impact different attitudinal or behavioral factors or not. Searching the PubMed and PsycInfo databases with different keyword strategies supplemented with reference section searches, we found 52 relevant papers for review. For each distinct study, we extracted information regarding: sample characteristics and related analyses, procedures and methodology, factors investigated, results, and effect sizes. Overall, we found that the samples were heavily constituted of women, of students and younger participants, with little information about representation of ethnic minorities. Procedures and methodology relied strongly on the use of experimental manipulations and a wide array of scales, including scales created by researchers. Several studies suggest the static and consequential properties of belief in free will. However, these conclusions are restrained by numerous limitations of the supporting body of evidence and the absence of replication studies. (shrink)

Free will skepticism is the view that people never truly deserve to be praised, blamed, or punished for what they do. One challenge free will skeptics face is to explain how criminality could be dealt with given their skepticism. This paper critically examines the prospects of implementing legal changes concerning crime and punishment derived from the free will skeptical views developed by Derk Pereboom and Gregg Caruso. One central aspect of the changes their views require is a concern for reducing (...) the severity of current forms of punishment. The paper considers two strategies for pursuing such a reduction. By taking into account evidence from the psychology of belief in free will and desire to punish, it is argued that a strategy aiming at a reduction of people’s natural desire to punish criminals can be successful if capable of providing alternatives to current forms of punishment satisfying three properties: they must be less harmful than current forms of punishment, more effective in preventing crime, and incompatible with current forms of punishment. (shrink)

Neuroethics is a dynamic and still rather young interdisciplinary field involving neuroscience, philosophy, or bioethics, among other academic specialties. It is under a process of institutionalization on a global scale, although not at the same pace in every country. Much literature has been devoted to the discussion of the purpose and relevance of neuroethics as a field, but few attempts have been made to analyze its local conditions of development. This paper describes the advancement of neuroethics in Japan as a (...) case study on the ups and downs of the institutionalization of a new academic field. As one of the peculiarities of neuroethics is the diversity of its constituent subject areas, which range from ethics of neuroscience to neuroscience of ethics, the analysis relies on a framework delineating its different aspects. The discussion of the Japanese case study is embedded in several interpretations of the significance of the field proposed by various actors, proponents, or detractors of neuroethics. The history of neuroethics in Japan can be read as a contribution to meta-neuroethics by those interested in definitions of neuroethics, and as a study in science policy by those interested in the Japanese system of research. (shrink)

Psychopathy, executive functions, and neuropsychological data: a response to Sifferd and Hirstein.

Does having a mental disorder, in general, affect whether someone is morally responsible for an action? Many people seem to think so, holding that mental disorders nearly always mitigate responsibility. Against this Naïve view, we argue for a Nuanced account. The problem is not just that different theories of responsibility yield different verdicts about particular cases. Even when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied that a more nuanced (...) approach is needed. (shrink)

As a neurodevelopmental condition that affects cognitive functioning, autism has been used as a test case for theories of moral responsibility. Most of the relevant literature focuses on autism’s impact on theory of mind and empathy. Here I examine aspects of autism related to executive function. I apply an account of how we might fail to be reasons responsive to argue that autism can increase the frequency of excuses for transgressive behavior, but will rarely make anyone completely exempt from moral (...) responsibility in general. On this account, although excuses may apply more often to autists than to others, the excuses that apply to autists are just the same excuses that can apply to anyone. (shrink)

In the present manuscript, we comment upon a paper that strongly criticized an expert report written by the consultants of the defense in a case of pedophilia, in which clinical and neuro-scientific data were used to establish the causal link between brain alterations and onset of criminal behavior. These critiques appear to be based mainly on wrong pieces of information and on a misinterpretation of the logical reasoning adopted by defense consultants. Here we provide a point-by-point reply to the issues (...) raised in the above paper and also discuss the potential role that neuroscience may contribute in the forensic context. Did the forensic neuroscience defense consultants claim the existence of a deterministic relationship between brain structure or function and behavior? How did the neuroscientific logic work in this specific case? How may the classic psychiatric/neurologic examination and neuroscientific evidence work side by side? Does the rarity of a disease impact on the causal relationship between the disease and the crime? Do neuroscientific data need to be interpreted? We address the above questions and conclude that neuroscience may strengthen the results of psychiatric evaluations, thus reducing uncertainty in the forensic settings. (shrink)

Responsible Research and Innovation is an important ethical, legal, and political theme for the European Commission. Although variously defined, it is generally understood as an interactive process that engages social actors, researchers, and innovators who must be mutually responsive and work towards the ethical permissibility of the relevant research and its products. The framework of RRI calls for contextually addressing not just research and innovation impact but also the background research process, specially the societal visions underlying it and the norms (...) and priorities that shape scientific agendas. This requires the integration of anticipatory, inclusive, and responsive dimensions, and the nurturing of a certain type of reflexivity among a variety of stakeholders, from scientists to funders. In this paper, we do not address potential limitations but focus on the potential contribution of philosophical reflection to RRI in the context of the Ethics and Society subproject of the Human Brain Project. We show how the type of conceptual analysis provided by philosophically oriented approaches theoretically and ethically broadens research and innovation within the HBP. We further suggest that overt inclusion of philosophical reflection can promote the aims and objectives of RRI. (shrink)