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Institute of Medicine (US) Forum on Neuroscience and Nervous System Disorders. From Molecules to Minds: Challenges for the 21st Century: Workshop Summary. Washington (DC): National Academies Press (US); 2008.

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From Molecules to Minds: Challenges for the 21st Century: Workshop Summary.

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Ethical Considerations

The brain is an object of great fascination and power. It is the seat of humanity, the source of everything we are and everything we want to be.

Understanding how the brain works—really understanding, on a core physiological level—would have tremendous benefits for society. But it would also raise significant moral, ethical, and practical considerations, which neuroscience must address carefully as it moves forward.

“I think it is useful to realize that neuroscientists do operate in a kind of interestingly sensitive area,” said Moreno. “As the old saying goes, just because you are not paranoid doesn’t mean somebody is not following you.”

As Moreno explained, people become nervous when they hear questions such as “How does the brain work?” and how to intervene in the brain. “The idea that scientists can have what I call technologically mediated access [to the brain]—can use devices or drugs, fancy machines that most of us do not really understand . . . I think is of great concern to many people and is something that, going forward, the community needs to think about,” said Moreno.

A comparison was made to the Human Genome Project, which attracted a great deal of concern from both the public and professional ethicists because it edged so closely to the foundations of life. Ultimately, extensive education and careful restrictions convinced people that the genome project was a safe idea, but only because its backers addressed the topic directly and in a public manner. Understanding “how the brain works” raises similar issues, and must be discussed, examined, and considered in the same light.

Clinical Concerns

Moreno raised a number of additional areas where ethics should impact the work of researchers. For instance, in clinical trials, it is possible that neurological interventions could change people’s sense of themselves. How can these kinds of changes be measured, monitored, and understood, not only as they happen, but in the process of obtaining informed consent and in the investigative process itself? In a similar vein, Moreno pointed out, as we develop a better understanding of the presymptomatic risk factors for certain diseases, the issue of how to notify research subjects of their likelihood of developing neurological disease becomes a major concern. This is already a live challenge in diseases such as the debilitating and deadly Huntington’s disease, which can be diagnosed in a presymptomatic state, but is invariably fatal. Expanding capabilities to identify disease on a presymptomatic basis would expand the potential treatment options of these challenges exponentially.

Fostering a Dialog

Throughout the discussion, ethical and morals concerns were raised. The ongoing discussion of learning disabilities, for instance, and the potential to intervene and mediate disorders medically, caused concern among many on the question of streamlining and mainstreaming in education and the cost to society of losing diversity within the population. Similarly, discussions of transhumanism—supercharging the brain—made some hesitant, while others saw it as a means to help the elderly regain function.

The overarching point was that neuroscience stands on the cusp of huge advances, and those huge achievements raise major issues that the field has never considered before.

“The time is really now to start thinking about what that means and how we want to . . . self-regulate and engage in better professional forethought as to how the impact of what we are doing inside our laboratories is actually reaching beyond the borders of our community,” said Insel.

The community was acutely aware that if they do not self-regulate their efforts and engage the public in a focused dialogue on the issue of neuroscience, politicians and other nonscientists will do it for them.

Copyright © 2008, National Academy of Sciences.
Bookshelf ID: NBK50997

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