4. Advanced understanding and monitoring of
human thought and behavior
Brings new ethical, social and legal issues
forward
Enabled by modern neurotechnologies
5. Can now quantify personal behaviors
Social attitude, value and moral agency
Akin to modern genetics
Prediction of disease, privacy, identity
Must carefully and properly interpret
relationship between brain findings and
concept of self
6. Must tackle practical questions in
neuroimaging
Interpretation is fundamental
Ethics of genetics are not a sufficient guide
Not apart of traditional bioethical analysis
8. The Good, the Bad and the AnteriorCingulate
(2002)
Morals and the Human Brain: AWorking
Model (2003)
Strategizing the Human Brain (2003)
The Medial Frontal Cortex and the Rapid
Processing of Monetary Gains and Losses
(2002)
The Neural Basis of Economic Decision-
Making in the Ultimatum Game (2003)
9. How the Mind Reads other Minds (2003)
Tapping the Mind (2003)
WhyWe’re So Nice:We’reWired to Cooperate
(2002)
There’s a Sucker Born in Every Medial
Prefrontal Cortex (2003)
10. “Thought maps”
Quantitative profiles of brain function
“Thought maps”
Not restricted to medical research and clinical
neuropsychiatry
Natural relevance in our daily life
11. Introduces many possibilities/desires
Assessing truth of statements and memory in law
Profiling prospective employees for professional
and interpersonal skills
Evaluating students for learning potential
Selecting investment managers to handle
financial portfolios
Choosing life partners based on compatible brain
profiles
12. Raises a number of epistemological issues
The study of knowledge
What is knowledge, how can it be accessed, how can
it be used?
Proper interpretation
Scientific level
Complexity of neuroscience research – integration
and interpretation of neuroimaging data
Social and cultural level
Social interpretations, bound by cultural and
anthropological frameworks
13. Most prominent tools:
Electroencephalography (EEG)
Magnetoencephalography (MEG)
Positron emission tomography (PET)
Single photon emission computed tomography
(SPECT)
Functional Magnetic Resonance Imaging (fMRI)
14. 1929, Hans Berger
Invented electroencephalogram
Relative signal strength and position of electrical
activity generated at level of cerebral cortex
Measured using electrodes placed on scalp
Evoked EEG response, “event related potential”
First tool used to reveal fundamental knowledge
behind the operation of the human brain in real
time
15. Other imaging methods took advantage of
brain signals
Extracranial electromagnetic activity (MEG)
Metabolic activity and blood flow (PET SPECT)
Regional blood oxygenation (fMRI)
All imaging methods use
comparison/subtraction between two
controlled conditions
16. All imaging methods use heavy statistical
processing and computer intensive data
reconstruction
Ultimately produce the familiar and colorful
maps
Used for diagnosis/intervention
of trauma, dementia, stroke, etc.
17. fMRIs will have greatest impact
Widespread availability of MR scanners
Imaging approach is non-invasive
Model for neuroethical discussions
Relative difference between experimental and
control (baseline) task
Surplus of oxygenated blood recruited to
relatively active brain regions produces effects
measured by MR
18. fMRI used alone or in combo with previously
mentioned techniques in studies
Lying and deception
Human cooperation and competition
Brain differences in violent people
Genetic influences
Variability in patterns of brain development
Investigation of unio mysticia using EEG, fMRI,
and PET
“Spiritual neuroscience”
19. Personal neuroprofiles ripe for bioethical
consideration
Neuroscience and philosophical questions
Existence limits
Meaning of free will
Distinguishing truth from lies, false memories
from real ones
Prediction of behavior
21. 1985 –Ake v. Oklahoma
Glen Burton Ake murdered a couple, wounded
their two children
Acted bizarrely in court, prompted judge to order
psychiatric competency evaluation
Report resulted in identifying Ake as delusional
▪ Claimed to be ‘Sword ofVengeance’ and will sit at the
left hand of God in heaven
Diagnosed as probable paranoid schizophrenic
▪ Is he competent to stand trial?
22. Ake’s attorney requested the court appoint a
psychiatrist to evaluate him for purpose of
insanity defense
Criminal defendants argue this should include
scans like PET and MRI
What do you guys think? DoesAke get
evaluated?
23. The court says, nope!
Upheld that he had no such right to assistance
Ake was then tried
Convicted of 2 counts of murder
Sentenced to death
24. Conviction overturned!
Ake was not provided a psychiatrist
Deemed unfair trial
Found guilty again, this time just life in prison
25. Should neuroimaging be used regardless of
offences?
Do they ‘deserve’ it?
Burden of the state?
Unfair advantage?
Keep in mind: PET previously has shown poor
functioning in prefrontal cortex of criminals
Locus of impulse control
26. PET images have been used to argue that
defendant was biologically predisposed to
committing a crime
Further argued they should be spared
conviction or death sentence
27. 1994 – People v. Jones
Homicide conviction overturned
State failed to provide brain scans
1992 – People v.Weinstein
Accused of strangling his wife to death, throwing
her body from 12th floor
PET, MRI showed arachnoid cyst, used for insanity
defense
28. 1992 – People v.Weinstein
PET scan showed juxtaposition between black
cyst and red/green colored “normal” areas
Juxtaposition was apparently “profound”,
apparent his brain was not functioning normally
Convicted of manslaughter
Thoughts?
29. 2001 – Langleben et al.
fMRI study
Approach to truth verification, “brain fingerprinting”
Participants with/without playing cards
Boils down to “lying takes more energy”
Results consistent with studies done in 1997 and 2003
Can also determine if deception is premeditated
Thoughts? Is brain fingerprinting legitimate?
Should it be used in court?
30. Brain fingerprinting
Terry Harrington, convicted of murder of retired
police officer in 1977
▪ Underwent brain fingerprinting in 2000
▪ EEG patterns suggested he was innocent
▪ Original prosecution witness recanted statement when
presented with this evidence
32. Health information is not entirely private
This can lead to denial of
Health insurance
Employment
Education
Financial loans
33. Neuroimaging provides insights into range of
higher cognitive functions
Many do not have good animal models
Studies touch on areas of profound societal
importance and controversy
Race relations, economic justice, perceived
trustworthiness, moral reasoning, economic
cooperation, social rejection, consumer
brand attachment
34. Ability to predict behavior raises many
concerns
Mind-reading
Social control
Novelty and extent of neuroimaging data
gives info on human health, behavior and
cognitive fitness
Raises concern
35. How much of this info will be used to benefit
mankind?
Can the info be used for harm or purposes
with ill-intent?
How will neuroimaging affect our daily life?
Work, education, financial, social interactions
36. Prediction of future behavior/pathology
Screening for team players and weak
decision-makers in the workplace?
Post-Columbine era
Screening students for predisposition to unruly or
violent behavior?
37. Post 9/11 era
Screening for terrorists?
Perhaps a brain scan at the airport?
Detention of individuals who have not yet
committed a crime
DSPD – Dangerous Severe Personality Disorder
Type I and II errors – statistical threshold
Cost vs. detaining past sentence (which can be legal)
38. Pedophiles
January 22nd, 2002 – US Supreme Court states:
▪ Can confine violent sexual offenders beyond their prison term
▪ Only if shown they have mental/personality disorder making
it difficult to control behavior
Very likely future imaging studies will be used to
determine felon’s ability to control behavior
More effective than behavioral test
39. So, back to pedophiles!
Megan’s Law
Information on sex offenders available to public
What if brain scans can be used to identify
potential pedophiles among non-criminal
persons
Who should scan? How should the data be used?
Should identified persons be registered? Should it be
made available to employers?
41. Incidental findings
“Observations of potential clinical significance
and unexpectedly discovered and unrelated to the
purpose of variables of the study”
Found in up to 10% of neuroimaging research
How should they be handled? In what way?
What should be done?
Abide by legal and ethical principles in
research/medicine
42. Risks
Emotional burden, possible unnecessary
procedures
Benefits
Early detection of something that can be
treated/prevented
How about opportunity to waive right to
receive info on incidental findings?
43. Case Study!
FE is 65 yo female fMRI volunteer
Study is for osteoarthritic knee pain
Found to have ischemic changes in left temporal
lobe during brain scan
She had no neurological deficit, did not complain
of discomfort
What would you do?
44. What actually happened
PI was clinician, decided to disclose findings
With her permission contacted physician for follow
up
FE developed neurological deficits 24 hours
later, underwent repeat neuroimaging and
treatment
Diagnosis of ischemic temporal lobe
Survived after treatment
45. Afterwards, PI and team felt distressed and
unequipped in dealing with incidental
findings
Wished for clear documentation of whether
patient wanted to be informed
Addressed lack of standard guidelines, protocol,
training, knowledge regarding legal and ethical
principles
46. Canada – all known foreseeable risks (even rare
and remote) must be disclosed to research
participants or surrogate decision-maker
Guided by Halushka v. University of Saskatchewan and
Weiss v. Solomon
No mention of whether foreseeable incidental
findings should be regarded as potential risks/harms
No clear guidelines as to when and what to disclose in
best interests of the patient
Thoughts?
48. Goal of marketing is to match products with
people
Guide design and presentation of products to
increase compatibility with consumers
Facilitating choice process of customer
Neuroeconomics – incorporating
neuroimaging into decision-making sciences
49. Hope among marketers neuroimaging will
streamline marketing processes while saving
money
Obtain customer information that cannot be
acquired using conventional methods
Some companies market neuromarketing
itself
50. More accurately indicate underlying
preferences than standard market data
Remains insensitive to biases
Efficiently allocate resources
Product concepts tested rapidly
Unpromising concepts eliminated early
Can now focus on promising products
51. Banned in France
Eye-tracking, galvanic skin response still legal
Misinterpretation and over-interpretation an
issue
Video:
http://www.youtube.com/watch?v=Ajg0ypD
D7i0
52. Unsettling?Creepy?
Is it ethical?
Need to respect autonomy, confidentiality,
privacy
Informed consent? Full disclosure of risk or harm
▪ How invasive are the procedures?
What exactly can the data be used for?
53. Protecting the vulnerable
Children, psychiatric patients, prisoners
Can be easily influenced
▪ Easily deceived and/or experience negative affected
Commercial use of data from these groups
Is it justified? Can it be defended?
54. Baylor College of Medicine
Pepsi vs. Coca-Cola
fMRI showed consumers prefer Pepsi
▪ 5x the response in ventral putamen
When repeated unblind…
▪ Nearly all participants prefer Coca-Cola
▪ Medial prefrontal cortex was activated – linked to sense
of self
▪ Brand is so attractive its overriding our taste buds?
55. Are you comfortable with neuromarketing?
Should lines be drawn?Where?
What can the information be used for?
Do the risks outweigh the benefits?
Do we care that much about finding products that
suit us?
56. Neuroethics is still young
Many unaddressed situations
Neuroscience “boomed” in early 21st century
Utilizes neuroimaging
EEG, MEG, PET, SPECT, fMRI
Massive impact on bioethics
Law, Discrimination/Stigma, Incidental findings,
Neureconomics/Neuromarketing, etc.
57. However, brain imaging is extremely useful
Understanding how our brain functions, diagnosis
of disease, detecting abnormalities
Interpretation is the key issue
Scientific and social level
Should lines be drawn?Where do we draw
the line?
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Challenge Informed by Genetics. The AmericanJournal of Bioethics :
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