GUMC Hosts “Gray Matters” Symposium on Ethics in Neuroscience

APRIL 29, 2015 – Ethics can be a head scratcher – even for neuroethicists.

But Stephen L. Hauser, MD, contributing author of a report by the Presidential Commission for the Study of Bioethical Issues, is helping to tackle the ethical issues head-on. On April 27, he joined a half-day symposium hosted by the Pellegrino Center for Clinical Bioethics at Georgetown University Medical Center to discuss the commission’s report titled Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society (new window).

The impetus for the report is the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative (new window), launched by the Obama Administration to revolutionize our understanding of the human mind and uncover new ways to treat, prevent and cure brain disorders. The report highlights three critical bioethical issues: the capacity for consent, questions of cognitive enhancement and the use — and misuse — of neuroscience in the legal system.

“The symposium provided an opportunity for the public — as well as Georgetown faculty and students — to gain insight to key neuroethical issues arising in and from the BRAIN Initiative,” said James Giordano, PhD (new window), organizer of the symposium and chief of the Neuroethics Studies Program at the Pellegrino Center for Clinical Bioethics.

Georgetown faculty members and Presidential Commission staff joined Hauser in presenting at the symposium.

Who Can Consent?

The issue of capacity for consent presents neuroscientists with a Catch-22. To develop treatments for neurological diseases, patients need to be studied. But patients with neurological diseases often have a diminished capacity to consent to participate in such studies due to their illnesses.

“We really need to involve people affected by these conditions,” said Michelle Groman, JD, associate director of the Presidential Commission for the Study of Bioethical Issues. “To not move forward with this research is to deny people the benefits of research, to deny potential prevention, treatment and cures.”

In its report, the commission suggested additional research to close knowledge gaps about impaired consent capacity. It also recommended reducing stigma around patients with neurological diseases and establishing clear requirements for legally authorized representatives of adults with diminished capacity for consent.

Cognitive Enhancement

Cognitive enhancement can run the gamut from ingesting a daily dose of caffeine to modifying specific behaviors. The ethics of cognitive enhancement, then, depend on what is being enhanced and by how much.

Report author Hauser noted that the debate over the ethics of cognitive enhancement has mostly involved improving cognition of otherwise healthy adults. But in their report, the commission included cognitive modulation in specific populations. Hauser pointed to a study that was able to manipulate memories in mice. “Imagine if one could erase the memories of tragic events in the mind of a person with PTSD,” Hauser said.

Cognitive enhancement could also prove useful for older adults who experience memory loss or loss of focus. Hauser pointed to a study published in Nature last year that restored 70-year-olds to the memory capability of a 30-year-old after two weeks of training.

Father Kevin Fitzgerald, PhD (new window), Dr. David P. Lauler Chair for Catholic Health Care Ethics at GUMC, raised the question of boundaries. “If we get to the point where we are able to go in and adapt behaviors, what if we had the opportunity to take a little boy who can’t walk, and not just make him walk but make him run faster than any other boy his age?” posited Fitzgerald.

“The commission was unified around the idea that there was nothing inherently unethical about enhancing neural function,” said Hauser, “but we had different ideas about where the boundaries of acceptability may lie.”

The commission’s recommendations included prioritizing existing strategies to maintain and improve neural health, prioritizing treatment of neurological and psychiatric disorders, supporting research on neural modifiers and ensuring equal access to useful treatments.

Legal Implications

According to Hauser, the intersection of neuroscience and the legal system is expanding.

“Defendants are using science to convince juries of their innocence, so we need to be sure that the science is accurate,” said Hauser.

There are several ethical issues involving neuroscience in the legal system. Some experts contend that certain science is simply not ready to be used in legal decision-making. Others believe that the interpretation of science in the courtroom is not accurate. For example, a study that might show clear neural differences on a population level might not have the same — or any — implications on an individual level. And then there are the privacy issues.

“We’re certainly not there yet, but we might be on the threshold of being able to interrogate the neural system in ways that may reveal attributes that we had intended to keep private,” said Hauser.

The commission’s recommendations in the legal arena involve learning more. The commission suggested expanding and promoting educational tools to aid in the understanding and use of neuroscience in the legal system, funding research that studies the intersection of neuroscience and the legal system and enlisting neuroscientists as experts to ensure that attorneys, judges and juries understand the significance of neuroscience.

“The symposium afforded both commentary to the Commission’s report, and in so doing, a broader view of neuroethical topics and their relevance to healthcare, public life and law,” said Giordano.

For the full list of speakers, click here (new window).

Leigh Ann Renzulli
GUMC Communications