Current Ethical Issues in Neuroimaging

Adina RoskiesDartmouth 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