Gray Matters Volume 2 Seeks To Counter Hype With Discussion

Today the Presidential Commission for the Study of Bioethical Issues released the second volume of its Gray Matters report, the ninth report by this commission.  The report was requested by the President following the announcement of the BRAIN Initiative.  He requested that the Commission identify a set of core ethical standards to influence neuroscience research and to address some of the debates emerging from applications of that research.

Volume One, released in May 2014, focused on how to fully integrate ethics into neuroscience research throughout the research cycle.  Volume Two concerns ethics in applications of neuroscience research, with an emphasis on three topics that have attracted some level of debate: cognitive enhancement, the capacity of a being to consent (to research conducted on them), and neuroscience in the law.  Through these cases the Commission wanted to tease out relevant ethical considerations and related tensions brought out by the potential impacts of these technologies.

There are fourteen main recommendations in the report:

Prioritize Existing Strategies to Maintain and Improve Neural Health

Continue to examine and develop existing tools and techniques for brain health

Prioritize Treatment of Neurological Disorders
As with the previous recommendation, it would be valuable to focus on existing means of addressing neurological disorders and working to improve them.

Study Novel Neural Modifiers to Augment or Enhance Neural Function
Existing research in this area is limited and inconclusive.
Ensure Equitable Access to Novel Neural Modifiers to Augment or Enhance Neural Function

Access to cognitive enhancements will need to be handled carefully to avoid exacerbating societal inequities (think the stratified societies of the film Elysium or the Star Trek episode “The Cloud Minders“).

Create Guidance About the Use of Neural Modifiers
Professional societies and expert groups need to develop guidance for health care providers that receive requests for prescriptions for cognitive enhancements (something like an off-label use of attention deficit drugs, beta blockers or other medicines to boost cognition rather than address perceived deficits).

Responsibly Include Participants with Impaired Consent Capacity in Neuroscience Research
Responsible inclusion means proper consent procedures, with additional protections that recognize relevant cognitive limitations and aim to ensure the equitable diffusion of benefits from this research.
Support Research on Consent Capacity and Ethical Protections
As with many areas of neuroscience, there are gaps in knowledge, including in impaired capacity consent.
Engage Stakeholders to Address Stigma Associated with Impaired Consent Capacity
Ethical neuroscience research can improve understanding of mental illness and address the stigma(s) associated with it.
Establish Clear Requirements for Identifying Legally Authorized Representatives for Research Participation
It’s important to ensure that those not able (cognitively and/or legally) to provide consent can have representatives able to act on their behalf.
Expand and Promote Educational Tools to Aid Understanding and Use of Neuroscience within the Legal System
Those trained in the law, or participating in the legal system, need to understand the fundamentals of the neuroscience that underlies the relevant case(s).
Fund Research on the Intersection of Neuroscience and the Legal System
There is a need to develop the body of knowledge on how neuroscience is used in the legal system and its limitations.
Avoid Hype, Overstatement, and Unfounded Conclusions
When using neuroscience in the legal system, the evidence behind it needs to be reliable and validated.  The newest findings are not likely ready for use in the legal arena.
Participate in Legal Decision-Making Processes and Policy Development
Neuroscientists need to engage with the legal system when it attempts to use neuroscience in its proceedings.
Establish and Fund Multidisciplinary Efforts to Support Neuroscience and Ethics Research and Education

The report also notes with regret the recent passing of Commission member Dr. John Arras.  He held appointments at the University of Virginia in biomedical ethics, philosophy and public health and conducted research in physician-assisted suicide, rationing of medical care, and social disparities in health and health care.

The Commission next meets in late May.


One thought on “Gray Matters Volume 2 Seeks To Counter Hype With Discussion

  1. Pingback: Gray Matters volume 2: Integrative Approaches for Neuroscience, Ethics, and Society issued March 2015 by US Presidential Bioethics Commission | FrogHeart

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