Neuroethics: Neuroscience's Contributions to Bioethics

There are mounting claims and expectations that neuroscience will transform bioethics scholarship and practices as well as related social science disciplines. Wolpe has described such wide‐ranging implications of neuroscience as a ‘neuroscience revolution’.[1] Similarly, Weisberg and colleagues, commenting on the public impact of neuroscience, write that ‘[n]euroscience research has the potential to change our views of personal responsibility, legal regulation, education, and even the nature of the self’.[2] Roskies argues that, ‘[a]s we learn more about the neuroscientific basis of ethical reasoning, as well as what underlies self‐representation and self‐awareness, we may revise our ethical concepts’.[3] She describes this promise as a neuroscience of ethics,[4] which deals with fundamental concepts of human agency and morality (e.g., free will, self‐control, personal identity, moral judgments) and how neuroscience could change them based, for example, on neuroimaging research.

There is an increasing body of scientific research seeking to provide neural explanations for basic human behaviours and social norms such as altruism, reciprocity, gender typical behaviour, moral decision making, free will, empathy, psychopathy, and antisocial behaviour. This radical shift within the field of ethics in general, and bioethics in particular, promises, according to some, to enhance our understanding of ourselves and of our fellow human beings. Neurobiologist Changeux has pioneered such epistemological arguments by claiming that neuroscience knowledge will be a route to foster happiness in individual lives and social wellbeing.[5] The cognitive neuroscientist Michael Gazzaniga states likewise that neuroscience will bring radical changes to ethics and he summons neuroethics to be ‘an effort to come up with a brain‐based philosophy of life’.[6] Levy holds that neuroscientific research offers us new tools that result in a whole ‘new way of doing ethics’.[7] Such assumptions and claims bring forth a range of expectations in the public and in academia: decisions in both the United States and the European Union, to invest in the long‐term project of mapping the brain (NIH 2010, HBP 2012) are re‐emphasizing the major benefits and ethical challenges of neuroscience for medicine and society, which have already generated much controversy.

In 2014, with the generous sponsorship of the Brocher Foundation in Switzerland, we convened a two‐day workshop uniting experts in ethics, philosophy, and the neuroscience of ethics to discuss the implications of the neuroscience of ethics. Based on discussions at this workshop, this special issue of Bioethics features a series of reflections on the contribution of neuroscience to bioethics, notably because of the strong tradition of empirical ethics in bioethics.[8] Indeed, bioethics’ position at the intersection of ethics and biomedical sciences may be unmatched – within other forms of applied or contextual ethics – to explore the implications of neuroscience for ethics. The four contributions include a joint (and more encompassing) article resulting from the effort of many of the workshop participants as well as three more specific articles tackling issues related to autonomy, addiction, and moral enhancement.

In their article entitled ‘Can neuroscience contribute to practical ethics? A critical review and discussion of the methodological and translational challenges of the neuroscience of ethics,’ Racine and colleagues examine why the neuroscience of ethics is a promising area of research and summarize what has been learned so far regarding its most promising goals and contributions. The article reviews some of the key methodological challenges which may have hindered the use of results generated thus far. It also suggests strategies to address these challenges, improve the quality of research, and increase neuroscience's usefulness for applied ethics and society at large. Racine and colleagues conclude with a reflection of potential outcomes of a neuroscience of ethics including knowledge transfer and integration.

In their contribution, ‘Moral enhancement meets normative and empirical reality: Assessing the feasibility of moral enhancement neurotechnologies’, Dubljević and Racine review the literature on neuroscience and cognitive science models of moral judgment as well as the evidence on available neurotechnologies that could serve as tools of moral enhancement. Their contribution follows a fierce debate on the topic of moral enhancement triggered because the very idea of moral enhancement involves choosing amongst a wide array of competing options, and these options entail deciding which moral theory or attributes of the moral agent would benefit from neuroscientific intervention. Dubljević and Racine surmise that the predictions of rationalist, emotivist, and dual process models are at odds with the evidence, while different intuitionist models of moral judgment are more likely to be aligned with it. They conclude that the project of moral enhancement is not feasible in the near future as it rests on the use of pharmaceutical interventions and neurostimulation techniques, which have no real moral enhancement effects or, worse, have negative effects.

Racine and Rousseau‐Lesage (‘The voluntary nature of decision‐making in addiction: Static metaphysical views versus epistemologically dynamic views’) tap on an instrumentalist and scientifically‐informed account of free will developed based on the insights of recent research in cognitive science, social psychology, and pragmatist philosophy.[9] They use this so‐called instrumentalist analysis of the concept of free will to examine whether the voluntariness of the will (free will) is at stake in addiction. They argue that, in the context of research with persons with an addiction, this issue represents an important dimension of autonomy and of consent. However, debates up to now, with a few notable exceptions,[10] have generated extreme positions as to whether individuals with an addiction can offer informed and free consent or not. They argue that the basis for these extreme positions is a rather static metaphysical understanding of the nature of voluntariness. In contrast, a dynamic concept of the will and of voluntary action better accounts for varying levels of voluntariness of the person with an addiction. They offer suggestions regarding the theoretical and philosophical implications as well as its practical and ethical implications in clinical treatment and research and its methodological and research implications.

In the article ‘Respect for autonomy in light of neuropsychiatry’ Müller focuses on the pivotal bioethics concept of autonomy. She argues that the concept of autonomy rests on important empirical premises often encapsulated under the term ‘capacity’. Yet, while social influences to capacity have largely been discussed, neuro‐biological influences have been relatively rarely considered, notably also in the works of Beauchamp and Childress on principles of biomedical ethics.[11] An obvious area where brain pathology directly affects capacity is psychiatry. Consequently, Müller criticizes the still influential antipsychiatry movement for misunderstanding liberty of autonomy: thus, the ‘liberty to illness’ can be revealed as a flawed concept because in many of the severe psychiatric diseases liberty is extremely restrained by internal pathological processes affecting the brain. The author presents case vignettes of psychoses due to parasitic infections or autoimmune disorders with identifiable antibodies against parts of the brain. Finally, she argues for a careful examination of capacity and a nuanced assessment of patient autonomy while taking into account the diagnostic data and knowledge from the neurosciences. She concludes by contending that this is the only way to try to restore capacity and thus pay the utmost respect to patient autonomy.

We hope that readers will appreciate the contributions featured in this special issue and that they will serve as an encouragement for further research in this area.

We thank the Brocher Foundation for the support offered to the workshop that triggered this special issue project. Thanks to Sonja Chu for helpful comments on a previous version of this manuscript and for help in preparing the article for submission. Eric Racine is supported by a career award of the Fonds de recherche du Québec‐Santé and a grant from the Social Sciences and Humanities Research Council.