Brain In A Box McGill

Linda MacDonald Glenn

McGill University

Montreal

March 18, 2005

Brain in a Box and other Brain in a Box and other Cognitive Curiosities:Cognitive Curiosities:Legal and Ethical Implications in Legal and Ethical Implications in NeuroEnhancementNeuroEnhancement

© 2005 L. MacDonald Glenn

Presenter• Linda MacDonald Glenn, JD, LLM

• LL.M. in Biomedical Ethics from McGill University, Montreal, Canada, 2002

• Former Senior Fellow, Institute for Ethics, American Medical Association and Current Women’s Bioethics Project Scholar

• Adjunct Assistant Professor, Lecturer, Writer and Consultant. Recent publications: Ethical Issues in Transgenics and Genetic Engineering at www.actionbioscience.org and Neuroethics, Criminal Responsibility and the Law, Summer 2004 ASBH Exchange, and Biotechnology at the Margins of Personhood: An Evolving Legal Paradigm, available at www.jetpress.org

• Coined the phrase “evolving notions of personhood”• In a previous life, a trial attorney • Director, Board of the Converging Technologies Bar Association

Purpose of Presentation:1.) Current Developments in

Neurotechnologies 2.) Ethical considerations 3.) Legal implications


First, a little quiz…

1) How many of you went to private schools?

2.) How many took Kaplan or some other course to help with your SAT

scores ? 3.) How many wear contact lenses?4.) How many have body piercing?4.) How many of you know someone who

has had plastic surgery?


If you answered yes to any of these questions, ….

• If you answered yes to any of these questions, you, too, could be…an “enhanced human”.












Current Developments in Brain-Imaging

• Positron emission tomography (PETscan) is nuclear medicine imaging technique where radioactive 'tracer' isotopes which emit a positron are injected into a living participant (usually into blood circulation)

• Functional MRI (fMRI) relies on the magnetic properties of blood to enable scientists to see images of blood flow in the brain as it is occurring. Thus researchers can make "movies" of changes in brain activity as patients perform various tasks or are exposed to various stimuli.


Current developments, continued…

• An fMRI scan can also produce high-quality images that can pinpoint exactly which areas of the brain are being activated.

• But, fMRIs and PETscans have also detected residual cognitive function in persistent vegetative state and more cognitive function in “minimally conscious” patients.

• Evidence that neurons can regenerate, (i.e., with the help of stem cells) and that cognitive function can be restored/enhanced.

(Brain activation from fMRI shown as patch of colour on MRI scan)


Image Courtesy, Society for Neuroscience –Brain imaging with positron emission tomography (PET) reveals thedifferent regions of the human brain active during various verbal tasks.


Current developments, continued…

Combination with other data collection techniques such as

• Electroencephalogram (EEG), recording of the electrical activity of the brain, or

• Magnetoencephalography (MEG) the measurement of the magnetic activity of the brain,


Current developments, continued...

• Magnetic resonance spectroscopic imaging (MRS) is another, Nuclear Magnetic Resonance -based process for assessing function within the living brain. MRS takes advantage of the fact that protons (H) residing in differing chemical environments depending upon the molecule they inhabit (H2O vs. protein, for example) possess slightly different resonant properties


Enhancing drugs are here now

• Cognitive enhancement–Stimulants

Provigil

–Nootropics Piracetam

–Caffeine Starbucks

How we use these will influence future How we use these will influence future decisions about more powerful or invasive decisions about more powerful or invasive enhancing technologies.enhancing technologies.


PiracetamPiracetam::

Benefit has Benefit has notnot been rigorously been rigorously proven.proven.

European and European and internet market internet market estimated at estimated at billions of dollars.billions of dollars.






www.hedweb.comwww.biopsychiatry.com

www.lovedrug.com “the molecular biology of paradise”


• Healing– to restore, to preserve, to prevent human

malfunctioning and to put right what has gone wrong with the body.

• Enhancement– to exceed what is normal and to improve on

nature.

Distinction

In many cases the distinction is common In many cases the distinction is common sense. In other cases, where the two sense. In other cases, where the two categories overlap, it is less obvious.categories overlap, it is less obvious.


Tell me what you don’t like about yourself ….


Legitimate Enhancement• If restoring these lost capacities is considered legitimate,

– Eyeglasses– Hearing aids– Joint prostheses

• It may be difficult to defend the assertion that enhancing drugs should not be used to compensate for the decline in cognitive function that normally and universally occurs with aging.

• At what age is cognition normal?


What if there were a mental equivalent for Viagra?


To Enhance or Not: Is that the question?

• If we believe that the best way to modify human behavior is through drugs and implants , then Does Virtue becomes obsolete ? Is it easier to

take a pill? Do Human choices become less personal*? Is that you? Or you on drugs? If we are nothing but chemicals, does that

matter?




The possible costs of cognitive enhancement – TNSAFL (There’s No Such Thing As a Free Lunch)

• Possible Medical side effects–Headaches

–Anxiety

–Personality changes, e.g. irritability

–Insomnia

–Fatigue

• Only a redistribution of the brain’s chemical economy–Robbing one neurotransmitter supply to boost another

• Implants may exhaust the biological substrate or induce undesired epiphenominal effects by bypassing normal internal regulation & integration


• The ethical cost–What unintended personal, social, and cultural consequences

would result?•Enhanced ability may entail reduced self-control•Perfection an unattainable goal, can never be satisfied•A culture of drug or implant seekers

–What moral principles would be violated for the sake of the seemingly greater goal?

•Excessive concern for oneself and less for others•Modications may violate the fundamental nature and

integrity of the individual•Justice: the haves and the have-nots

Possible costs…


• How will these influence our definitions of “normal”?

• What should insurance pay for?

• Can such drugs be ethically used for the “normal”?

• How do we promote fairness in access, and avoid discrimination?


• As long as they do not subsequently engage in behavior that harms others, individuals should not be prohibited from, or criminalized for, using new mind-enhancing drugs and technologies.

• Assumes “enhancement” is benign. What if the harm occurs cumulatively or progressively over time?

• We prohibit other forms of self harm: seat belts, Schedule III, IV drugs, etc.

• What if agent alters or potentially alters capacity? By definition, if you lack capacity, you lack autonomy (Autonomy requires both capacity and liberty). What if the agent would (or potentially) alter the decisions made?


In Conclusion

Some questions we are left to ponder: • Who decides? You, the parents, the

“bioethicists” or the government?• If you’re not willing to outlaw cosmetic

plastic surgery, how can you ban cosmetic neurology and cognitive enhancements?

• Further discussion and attempts to reach consensus are desperately needed!!!


This slide sponsored by the maker of Prothink ®

• Do you feel inadequate to understand today’s bioethical questions?

• Do you lay awake at night struggling to solve bioethical dilemmas?

• If so, have you asked your doctor about Prothink?• The new cognitive enhancing drug to help you

– Focus your thoughts– Forget unpleasant information and outdated obligations– Lifts the emotional burden of feeling as if you were responsible for

other people– Helps you make the decision that’s right for you– The first pill to enhance your ability to think ethically

• Better ethics through neuropharmacology


Thank you for your attention!Thank you for your attention!

• For further info, references contact me at [email protected] or [email protected]

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