Current Ethical Issues in Neuroimaging

							Current Ethical Issues in
     Neuroimaging




               Adina Roskies
              Dartmouth College
      Presentation to the Presidential Commission
      for the Study of Bioethical Issues, February
                        28, 2011
      Neuroimaging
• Primarily diagnostic,
  descriptive/predictive, non-
  interventional
• Can be used in conjunction with
  interventional techniques like TMS,
  DBS which raise other ethical issues
• “We are our brains” more immediate
  than “We are our genes”
Parallels with HGP
       ELSI
•   Many similar informational risks
•   Some differences:
    •   potential to pose a different kind
        of privacy threat
    •   consent issues
        •   usually the information does not
            affect people other than subject
        •   neurological cases often involve
            competence
Privacy/potential forensic
 uses of neuroimaging
•   Mental Content
    •   MVPA allows prediction of visual content on
        basis of brain data (Mitchell et al, 2008,
        Shinkareva et al. 2008, Just et al. 2010)
•   Lie/truth detection
        •   knowledge/familiarity
            •   measures of arousal
            •   measures of subjective but not
                objective familiarity (Rissman, Greely &
                Wagner, 2010)
        •   pain
  Mental Privacy, Lie
      detection
• Techniques for assessing these better
  than chance, but:
 • experimental design problems
 • experimental confounds
 • unknown base rates (prevalence in
    the relevant population)
 • are apt to be misleading
• All these provide only probabilistic
  information
              Prediction
•   Prediction of brain disease
•   Potential forensic uses of predictive
    neuroimaging
        •   Aggression/Antisocial behavior
        •   Recidivism
        •   Mental illness
    •   Probabilistic information, no definitive
        predictions can currently be made
    •   In many cases, we don’t know
        baserates
          The ethics of
         consciousness
•   Recent developments in
    understanding/diagnosing disorders of
    consciousness
    •   Mental imagery (Owen et al., 2006, Monti et al.
        2010)
    •   Trace conditioning (Bekinschtein et al., 2009)
•   Ethical implications of these developments for
    extending life, pain management, quality of life
    considerations
•   Underlying importance of considerations of
    welfare and autonomy
        Responsibility and
           culpability
•   Biological picture puts pressure on
    commonsense notions of free will
•   Neuroscience puts pressure even a more
    sophisticated notion of free will (reasons-
    responsiveness)
•   How do we integrate the finding that biological
    factors affect ethical conduct with theories of
    responsibility?
•   Ethical issues arising from such understanding,
    including judgments of culpability, effects of
    interventions, ethics of interventions, etc.
              Public
        (mis)understanding
•   General scientific literacy
•   Specific problems with understanding
    neuroimaging data
    •   Mistaken beliefs in biological (genetic,
        neural) determinism
    •   Lack of recognition of brain plasticity and
        its consequences
    •   Lack of appreciation of extent of
        individual variation
    •   Difference ≠ dysfunction or disease
     Ethical questions
•   The ethics of privacy
•   The ethics of prediction
•   The nature and value of consciousness
•   Theory of responsibility commensurate with
    a scientific understanding of behavior
•   Consideration of the concepts of
    “authenticity” and “autonomy” and their
    connections to and relative priority
    regarding considerations of welfare and
    other values
 Other important policy
         issues
• Understanding range of individual
  variability is essential for proper
  interpretation of information, yet
  determination of such information not
  structurally encouraged
• Responsible education of public and
  media