Neuroscience and ethics goes global

It is almost a year now since we published our report on novel neurotechnologies. Maybe it is because we keep an extra eye out for these things, but it seems to me that barely a day has gone by in this year without us hearing in the media of one story or another that involves peoples’ brains. So far this month, for example, we’ve already seen reports of a new study into how we might restore memories, another into why we lose them in the first place and a new UK advertising campaign promoting dementia friends, to name but a few.

And today is another significant day for neuroethics, as we welcome the launch of the report ‘Gray Matters: Integrative Approaches for Neuroscience, Ethics, and Society’ from the United States Presidential Commission for the Study of Bioethical Issues. This report focuses on the need for, and models to achieve, integration of ethics early and throughout neuroscience research. A second report later this year will consider the ethical and societal issues of the products of neuroscience research, a focus more closely aligned with our own previous work.

Like our own report, Gray Matters points out that the ethical issues arising in the context of research involving the brain are not entirely unique. Many of the issues are relevant to other types of novel and investigative medical research, but the special role of the brain in human life is what gives it a particular status and drives concerns like autonomy, identity and privacy to the fore. Equally, both the Nuffield Council and Presidential Commission reports recognise the importance of neuroscience research in view of the number and severity of brain-related disorders that affect many millions of people worldwide.

Gray Matters makes a number of recommendations to all of those involved in neuroscience research – to the scientists themselves, to institutions, to funders and to government agencies - divided broadly into four main overarching routes to place ethics firmly at the centre of neuroscience research:

1. Integrate ethics early and explicitly throughout research
2. Evaluate existing and innovative approaches to ethics integration
3. Integrate ethics and science through education at all levels
4. Explicitly include ethical perspectives on advisory and review bodies

We very much endorse the call for innovation to proceed in an ethically responsible way that recognises sensitivities of these technologies and the particular vulnerabilities of those who might benefit from them. We also welcome the emphasis placed on the multiple layers of responsibilities incurred – no single set of actors can be expected to achieve ethics integration all on their own.

Our report raised many of the same concerns and priorities for ‘ethics integration’, simply under the different heading of ‘Responsible Research and Innovation’ (RRI). We specified several priorities for RRI in respect to novel neurotechnologies (see Chapter 6) which link with the recommendations above. In particular, our call for continuous and reflexive evaluation is strongly reiterated in the US Commission’s second recommendation, and there is a shared recognition of the importance of encouraging the many stakeholders from different disciplines to each have an understanding of research trajectories and ethical challenges.

We also recommended ethical education for neuroscientists in training, which ties in with the third point listed above. However, it is interesting to see the US Commission go further in pushing for the integration of science and ethics in education at all stages including high school (secondary) education. Here at the Council we are highly aware of the importance of promoting and facilitating high quality ethical debate amongst young people and have for some years been developing a programme of work in that area, initially with secondary students in mind (see our teaching resources) and more recently catering for even younger audiences. We have also done some work with schools theatre company Y-touring specifically on neuroscience and ethics, advising on their play which explores questions raised by progress in neuroscience around personality, identity, responsibility and liberty.

Another area where ethics integration will be important is in the regulation of neuroscience research. We gave a lot of attention to this in our own work, both in relation to the regulation of medical devices and of novel medical therapies that intervene in the brain. It is surprising that this is absent from the discussions in Gray Matters, but let us wait for Gray Matters: the sequel later this year. We see the role of regulatory systems not as a substitute for or an equivalent of ethical governance, but as an important tool in securing attention to vital ethical considerations, e.g. by ensuring, even at the research stage, that patients and consumers are not exposed to devices that have not been subject to appropriate levels of scrutiny regarding their safety and efficacy.

This report serves well to remind us that these issues are truly global in nature and we have welcomed the opportunity to contribute our own findings and ethical perspectives to the US Commission’s evidence gathering process. We eagerly await the follow up report tackling the complex societal and ethical issues arising from the products of neuroscience research - I’m sure there will be more to say. On this occasion it is not really a case of ‘Nuff said’ so much as ‘to be continued….’