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In Press: Ethics in Biology, Engineering and Medicine, 2014
Advancing Neuroscience on the 21st Century World Stage:
The Need for – and Proposed Structure of – an
Internationally-Relevant Neuroethics
Elisabetta Lanzilao1, John R. Shook2, Roland Benedikter3, & James Giordano 1,4,5*
1 Department of Graduate Liberal Studies, Georgetown University, Washington, DC, USA
2. Philosophy Department, University of Buffalo, Buffalo, NY, USA
3. Orfalea Center, University of California, Santa Barbara, CA, USA
4. Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University
Medical Center, Washington, DC, USA
5. Human Science Center, Ludwigs-Maximilians Universität, München, GER.
*Address all correspondence to: Prof. James Giordano PhD, Neuroethics Studies Program,
Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, 4000
Reservoir Rd, Bldg D, Suite 238, Washington, DC, USA 20057; Tel.: 202-687-1160; Fax:
202-280-1378; Email: jg353@georgetown.edu
ABSTRACT: Neuroscience has made ardent strides in assessing, accessing and engaging
the structure and function(s) of the brain through the use of ever more advanced and
sophisticated innovations in bio-engineering. Recent trends reveal the growth of
neuroscientific and neurotechnology (i.e. - neuroS/T) investments worldwide. The
internationalization of neuroS/T will likely influence – and be affected by – extant and newly
established asymmetrical relationships between developed, developing, and non-developed
nations. The speed, extent and power conferred by neuroS/T give rise to a number of
pressing ethical, as well as legal and social questions and issues, and are fostering wider
awareness, anticipation, and anxiety. The field of neuroethics addresses these issues and their
possible resolutions. But we query if and how neuroethics might be developed – and enacted
– to sustain international relevance, validity and value. Herein, we offer a model for an
applied, international neuroethics; starting from an overview and analysis of its socio-
political potential on a global level, we examine this model in light of Principlism and some
additional useful precepts and guidelines. We conclude by offering Rawlsian “reflective
equilibrium” as a bridge to Dower’s theoretical construct of ‘communitarian
cosmopolitanism’, and thereby yield a procedural method that satisfices our fundamental
premises and corollary principles.
KEY WORDS: neuroethics; neuroscience; neurotechnology; society; principles; cosmopolitanism;
communitarianism; globalism.
I. INTRODUCTION
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Neuroscience has made ardent strides in assessing, accessing and engaging the structure
and function(s) of the brain through the use of ever more advanced and sophisticated
innovations in bio-engineering and technology (i.e. - neurotechnologies). The past 10
years have borne witness to an accelerated pace of neuroscientific advancement, due in
part to both 1) expansion within its constituent disciplines, and 2) the conjoinment of new
disciplines and technologies (e.g.- genetics, nanoscience, cyberscience) under a
broadening rubric. The conveyance of neuroscientific developments into medical and
social contexts is accelerating. Challenges to long-held notions about the basis of
consciousness and the nature of the brain-mind-self relationship are in turn prompting re-
examinations into concepts of ‘personhood’ and various aspects of the person-in-society.
These developments are inevitably inspiring reflections and re-evaluations upon socially-
defined ontologies, values, and moral norms, along with ethical responsibilities involved
with constructs about the social and/or absolute “good”.
Such technical and epistemological shifts are “grand challenges” as proposed and
targeted by “big science” initiatives such as the Brain Research through Advancing
Innovative Neurotechnologies (BRAIN) project, an agenda to generate federal and private
subsidy in support of consilient research that seeks to establish US efforts in brain
science as part of a worldwide enterprise, inclusive of the European Union’s ongoing
Human Brain Project and the Asian Decade of the Mind program. The speed, extent and
powerful capabilities conferred by neuroscience and neurotechnology give rise to a
number of unavoidably pressing ethical, as well as legal and social questions and issues
(see Giordano1 for current overview), and are fostering wider public – and professional –
awareness, anticipation, and anxiety (See Table I)
Table I about here.
3
II. NEUROSCIENCE, NEUROTECHNOLOGY, AND NEUROETHICS ON – AND
FOR - THE 21ST CENTURY WORLD STAGE
Consistent with the revenues devoted to, and generated by, the aforementioned brain research
initiatives, economic predictions for 2020 confirm the rise of neuroscience and
neurotechnology (so-called neuroS/T) as dominant forces in global markets. Recent trends
reveal the growth of neuroscientific and neuro-engineering investments worldwide. Current
estimates claim that Asian neuroS/T research and development will surpass that of the United
States and Europe, acquiring a 60% increase in overall market growth within the next 5 to 7
years.2 Moreover, the internationalization of neuroS/T will likely influence – and be affected
by – extant and newly established asymmetrical relationships between developed,
developing, and non-developed nations.3,4
This situation is already prompting prudential inquiries about guiding and governing
the appropriate and justifiable applications of neuroS/T. The field of neuroethics has
been developed to address these issues and questions. Although still somewhat nascent,
in just over a decade neuroethics has assembled a considerable body of research, address
and application. Two main aspects or “traditions” have taken primacy thus far: 1) the
neuroscience of moral cognition, emotions, and behaviors for discerning how our moral
capacity (and ethical judgment) develops and functions; and 2) inquiry into ethical
questions about the use – and misuse – of neuroscience and neurotechnology in areas
such as health care, civic life, and national security.5,6,7
Given the reality that neuroS/T is, and is becoming, an ever more international
endeavor, we may anticipate how each country can separately pursue its own interests,
4
yet we might also seek normative premises for a neuroethics yielding a valid international
purview. In this respect, we must ask if and how the idea of a global community, if at all
possible,8,9 compels the ideal of universal ethical guidance, and does this ideal provide the
groundwork upon which some form of internationally valid neuroethical paradigm could
tentatively be built? Globalization has established conditions for restructured individual and
collective identities, which are often configured as new forms of cultural hybridization and
synthesis. These changing identities provided well-springs for novel ethical theories striving
to reach an accommodating and reasonable ‘mid-ground’ for theoretical and factual
conciliation between universalism and some kind of contextual socio-cultural specificity. We
assert that the valuable practicality of an internationally-relevant paradigm of/for neuroethics
depends on conciliating tensions between the ‘local’ and the‘global’ that so deeply affect the
definition, assessment, and implementation of neuroS/T research and applications.
To implement this global neuroethics project, we argue that two premises will be
essential. First, is the presumption that a global community, although conceptually self-
referential and unprecedented, already exists in some nascent form, and provides a valid basis
for a common moral frame.
i
Second, is that neuroethics – as a discipline and set of applicable
practices – should articulate a working normative paradigm designed for this international
context.From these premises, we further propose that an internationally relevant neuroethics
must follow four corollary principles: 1) it must be sensitive to pluralist views and be
liberated from prior hegemonic ideologies; 2) it must fully represent the contemporary reality
of the bio-psychosocial human being, as reciprocally engaged in and engaged by human
ecology; 3) it must embrace aspects of both individual and collective identity; and 4) it must
observe standards of objectivity sufficient for broadly justifying practical ethical positions.
Herein, we offer a model for an applied, international neuroethics meeting the
aforementioned criteria. Starting from an overview and analysis of its socio-political potential
5
on a global level, we examine this model in light of the principles of beneficence, non-
maleficence, respect for autonomy and justice (i.e.- Principlism10) and some additional
useful precepts and guidelines. Our tentative conclusion is that John Rawls’ “reflective
equilibrium” can serve as a bridge to Nigel Dower’s theoretical construct of
‘communitarian cosmopolitanism’,8 yielding a procedural method that satisfies (or at
least satisfices) our fundamental premises and corollary principles.
III. NEUROETHICS: “TRADITIONS” AND INTERNATIONAL CHALLENGES AND
OPPORTUNITIES
Neuroethics’ first “tradition” explores the putative neural substrates and mechanisms of
moral cognition, emotion, and behavior, thereby providing an understanding of the ways that
organisms relate to others, environments, and the sociocultural contexts in which they are
nested.11-17 We maintain that this could be more accurately described as studies into ‘neuro-
ecology’ – the neural bases of environmental interaction and action – so as to afford finer-
granularity to Roskies’5 description of neuroethics’ first tradition as the neuroscience of
ethics. Within our framework, a human being is fully acknowledged as a bio-psychosocial
entity, determining and determined by ecology, responsive and adapting to conditions, and
vulnerable to the predicament of injury, disease, and finitude. The human being is a
‘historicized’ actor, interacting with a circumstantial context and responding to a surrounding
contingent culture, which affects the “neurocognitive-emotional-environmental” dimensions
of this interaction, and shapes the expression of the ways that information, knowledge, and
tools are developed and used.18
Neuroethics’ second tradition examines the ways that neuroscientific techniques and
technologies are used, queries the modes through which neuroscientific findings are
applied, and addresses the ethical and socio-legal issues, questions and problems
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generated by neuroscientific research and its applications in medicine, public life, and global
relations.5,6,11,12,13,14 While methodologically derived and linked to basic and clinical
bioethics, we posit that neuroethics can focus on unique questions and problems generated by
studies of the brain and consciousness relating to any ethical inquiry, including persistent
“hard problems” inherent to neuroscience, and the unknowns surrounding any applications of
neuroscientific techniques and tools affecting humans and the human predicament.
As reflected by its growing corpus of literature, neuroethical issues range from the
philosophical to the juridical. This fortifies the pursuit of an organized, well-articulated
neuroethics initiative that explicitly addresses neuroscience, ethics, legal and social issues
(NELSI). Due regard for the social sphere, as our neuro-ecological framework requires,
prompts careful consideration of cultural diversity, as well as economic and political forces.7
Deep questions cannot be avoided at this level. How, for example, might neuroscientific
research, the clinical and social benefits provided by neuroscience, and the burdens, risks,
and harms that may be incurred through the misuse or purposive abuse of neuroscience and
its technologies be leveraged in the biological, psychological, socio-economic, and political
milieu of the 21st century world-stage?
The broad implications of this ambitious neuroethics must acquire global relevance,
particularly with regards to domestic and international policy-making.16,19,20 We claim that
neuroethics deserves the status of a recognized “social force” because it 1) provides a viable
analysis of how “moral” constructs are formulated, perceived, and decided upon by
individuals and societies, 2) addresses the ways that neuroscience influences such knowledge
and its meaning and use, and as such, 3) can be considered to be a “proto-political
discipline”.16 The idea of an internationally-relevant neuroethics is not merely geographical,
economic, or political, since it automatically arises from the global dimensions of its subject.
As we have emphasized, neuroethics follows neuroscience’s study of embodied brains, and
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the ways that brains generate cognitive activities and behaviors for all inter-personal and
social conduct, and addresses and employs neuroscience’s epistemic and technical tools
for controlling those functions on individual, group, and even population levels. The
informational basis of neuroethics – i.e. – the research produced by neuroscience – and
the realities of neuro-cognitive and behavioral variables, all reflect the abundant
pluralism (contributed by the diversity of individuals within world cultures), and inherent
peculiarities of specific individuals and socio-cultures.21,22
This multi-level dimensionality is presently underscored by worldwide discussions
of neuroscience and neuroethics.17,23 Hence, neuroethical issues are both global and
local, and neuroethics – as a discipline and in practice – must both reflect, and commit to
this diversity. The drive to “globalize” neuroscience and neuro-ethical deliberation is
hardly as easy as ecological principles may make it appear. Such a program requires a
redefined integrative and culturally sensitive framework for ethical inquiry, which
dictates 1) pragmatic assessment of neuroS/T capabilities and constraints; and 2)
responsibility to prudently use neuroscientific information, outcomes, and tools in the
social sphere.14 At face value, this seems reasonable enough, yet determining which sorts
of ethical system(s) and framework(s) such a broad-based neuroethics would provide,
along with developing, articulating, and sustaining these ethical guidelines in practice, is
also far from simple. The mere fact that socio-cultural pluralism imparts deep diversity in
individual, group, and community needs, values, and desires makes any attempt at
universal, or at least far-reaching ethical alignment an exceedingly difficult matter. At
the fore is the importance of considering whether such tasks – and the resulting
outcome(s) – will devolve to either frank ethical relativism, or ethical imperialism.
Acknowledging this potential pitfall is a vital first step toward deliberations leading to
8
the formulation of a system of neuroethics that could be universally plausible and
internationally tenable.
Elsewhere we have opined that in these terms, and within the framing of a (neuro) bio-
psychosocial model, neuroethics can be seen as a self-referential and self-contained “meta-
ethics” in its capacity to independently address 1) moral capacity, 2) moral practice, and 3)
moral principle.13,14,17 As we have re-emphasized here so far, neuroscientific knowledge (as
combined with biological, cognitive and social science) provides iterative information that
can – and should – be applied to the comprehension of human socio-moral capacities. This
growing body of information will inevitably foster revisions and/or adjustments to extant
theories of sociality and morality, inclusive of the ways that science and technology are
engaged and utilized.16,17 A fully developed neuroethics will have no choice but to undertake
a complete reevaluation of all culturally normative traditions, including moral systems and
ethical traditions. The only real question is whether neuroethics will instead arbitrarily halt at
some boundary that is deemed too sensitive for transgression. Understanding how humans
enact and follow normative belief systems is unavoidably universal for we are one species –
it is already too late to raise any demand that some protected sphere of life go unquestioned
and some moral value remain absolute. Cultural traditions are in the habit of demanding
specific absolutes for subsets of humanity. The destiny of neuroethics is to disregard
‘unquestionable’ absolutes for some, in the name of objective knowledge of our common
humanity for all. Neuroethics is already value-laden – the question we pose is: which values
shall it exemplify?
IV. TOWARD INTERNATIONAL RELEVANCE AND APPLICABILITY
People value their local contexts for good reason. Cultural traditions and social conventions
constitute the largest source of neuroethics’ philosophical foundations and normative
9
guidelines.17 There is ample literature to define, describe, and discuss the relevance of culture
to human ecology, inasmuch as biology shapes and is shaped by environment (see, for
example Ridley24). As described by Kwame Anthony Appiah,25 cultures are comprised of
“continuities and changes”, through which the identity of a society is redefined and
conferred. Cultural traditions can also account for social amenability and/or resistance to the
use of neuroscientific information and technologies to affect and modify the cognitive
functions and conduct of the individual, society and prevailing culture.17 Such socio-cultural
specificity at a local level can translate into normative fragmentation that can impede the
attempts at broader discourse (if not agreement) needed for sustaining an internationally-
relevant – and applicable – neuroethics. Does normative relativism at a cultural level forever
obstruct the pursuit of some universal norms valid at a global level? Previous philosophical
efforts of past centuries are not overly encouraging in that direction, but we must recall that
those efforts were not informed by the behavioral and brain sciences. As Fritz Jahr26
presciently noted some nine decades ago, while philosophy provides ongoing questions for
science to address, both philosophy and ethics must remain informed – and changed by – the
answers that science may provide.
Apropos Jahr’s invocation, the pursuit of a universally applicable neuroethical
principles dictates a more comprehensive view of what Levy has referred to as “the new
ethics of neuroethics”.27 In light of the pace and breadth of neuroS/T developments, and
especially if and when compared to the tempo of social progress and ethical revision, an
ethico-legal reflection upon new tools and constructs relevant to human activity in the
social and political realm is necessary, in order to effectively guide the social
manifestations of new tools and discoveries.16 As Toope has observed,20 increasing and
re-orienting social responsibility is a complex and slow process, particularly if and when
directed by national governments striving to define appropriate supportive policies.
ii
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V. THE VALUE OF MID-LEVEL PRINCIPLES
The idea of a broadly agreed-upon paradigm for a cross-cultural theory and practice of
biomedical ethics is found in Beauchamp and Childress’ proposal of a four-principled ethics:
beneficence, non-maleficence, respect for autonomy, and justice. In the absence of
philosophical consensus over ethical theory, the apparent flexibility and relative miscibility of
the Principlist approach offers a somewhat discreet commitment to a large-scale acceptance
and sharing of mid-level constructs applicable across cultural circumstances and contexts.10,21
Beauchamp and Childress’ original notion of a broadly-construed morality relied upon
moral intuition as a universally and trans-historically shared normative baseline for rational
judgment.10,21 Partially inspired by Rawls’ concept of “wide reflective equilibrium”,28
Beauchamp and Childress arranged their four principles as credible foundations grounding
wide-ranging ethical convergence. When taken together as a systematized approach, the
philosophical neutrality of the four principles is itself a valuable heuristic tool with which to
enact and assure dialogical exchange between “universal” moral standards to be
systematized, and “particular” variability in socio-cultural norms and moral standards that
affect if and how certain ethical “universals” are applied.
The intentionally undefined ranking of the four principles is however, a double-edged
sword. Principlism allows for flexibility and broad applicability, yet it also incurs criticism in
its lack of definitiveness and a tendency for confusion, if not tensions and conflicts, over how
to prioritize the principles in various situations and circumstances. However, it is important to
note that these principles are mid-level, and to be used prima facie by design and intent. We
view this as a potential benefit: such flexibility can be a valuable opportunity for individuals
to express preferences for options that are universally agreed upon to be granted – but not
enforced – for living with human dignity.29
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VI. NEUROETHICS: PRINCIPLISM RE-FRAMED
Basic Principlism ultimately gains plausibility from common moral intuitions, whatever the
source. Neuroethics has far more than folk intuitions and folk psychologies to work from.
Eric Racine claims that neuroethics should adopt bioethical methodologies and tools and
adapt them to the new challenges posed by neuroscientific progress.6 We agree; without
doubt, neuroethics can and should be seen as a field of ethics, and a sub-field of bioethics.
What distinguishes neuroethics is its distinctive neuroscientific field of investigation: studies
and manipulation of the brain and its functions, and the whole realm functions and manifest
events of what is colloquially referred to as the mind. In short, neuroethics can address “what
it means to be a thinking being”,30 and what it means to use neuroscience to investigate and
affect the nature of being human.13,14,18,31-33 Its broad and interdisciplinary applications can
foster a systematic inter-disciplinarity, and an ability to move beyond limitations of Western
philosophy and such philosophies’ characteristic ethical concerns.17
We posit that common ground can be identified in a broadly naturalistic approach
informing both bioethics and neuroethics, and the underlying conviction that social and
moral phenomena are helpfully illuminated by the biological and behavioral sciences.6,34
Instead of positing a narrow scientistic naturalism endemic to recent Western philosophy,
we prefer a looser and liberal naturalism, of the sort defined as ‘moderate’ naturalism by
Jonathan Moreno.35 Naturalism generally rejects foundationalism in any form as a
cornerstone for ethical inquiry,6 preferring embodied empirical approaches instead, and
the ‘moderate naturalism’ we advocate helpfully presumes a dynamic reciprocal
engagement between object and subject. Where is neuroscience’s proper place within this
moderate naturalism? In Moreno’s view, the scientific method as traditionally based upon
the experiential source of knowledge should be preferred, but science itself is but one
among many alternative valid products of human experience. Therefore, as Racine notes,
12
Moreno’s moderate naturalism pragmatically views ethical norms not as biological laws or
derivations from biological laws, but rather as rules codified by and within the cumulative
dynamic experience of a society.6 This epistemological and methodological openness, inter-
disciplinarity, and flexibility to integrate theoretical and practical perspectives are
methodologically crucial to the ecological and internationally-viable neuroethics herein under
investigation.
From such considerations, Shook and Giordano propose four guidelines to address the
reality and needs of an internationally-relevant neuroethics that are inspired by, and generally
aligned with, Beauchamp and Childress’ model of Principlism.17 Starting from the four
principles (i.e.- beneficence, non-maleficence, respect for autonomy, and justice), the
purview of each are addressed and either accepted or modified, in light of neuroscientific
trends in society, so as to offer innovative ethical constructs that are claimed to represent a
novel, principled neuroethics that is ecologically grounded and naturalistically supported.
Like Nussbaum and others, we want to preserve individual expression in cultural contexts;
like Racine, Moreno, and George Khushf36 we want to pragmatically respect neuroscience
and ethics working together (see also: Giordano31,32,37). In our model, beneficence evolves
into empowerment, so as to advance the capability of people to independently pursue their
own well-being with the ultimate purpose to fulfill their lives but not in ways that impugn the
freedom – and powers -of others; from non-maleficence, a principle of non-obsolescence
bespeaks a more proactive duty to sustain individual worth and value within a society,
beyond a simple assertion of non-harm. The concept of respecting autonomy “evolves” into
respecting self-creativity, as the right of persons to recreate themselves to pursue enrichment
in their lives; finally, citizenship extends the principle of justice beyond merely fair allocation
of scarce resources, to establish abilities to be a “free, equal, law-abiding, and participatory
citizen”.17
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VII. A WORLDVIEW FOR ‘MULTIPLY-SITUATED SELVES’
Universalism is implied, but not guaranteed, by core principles or ethical frameworks, as they
are constructed and/or enacted so as to afford meaningful articulation in international
contexts. Abstract universalism, as we have amply noted so far, can be as much a threat as an
opportunity for the moral growth and ethical achievement of real people in the world. Must
the price of neuroethical universalism be the reduction of individuals to abstractions
themselves? Ulrich Beck argues that the ‘cosmopolitanization’ that is actively changing
human experiential space should not nurture misleading convictions that all individuals and
institutions are becoming cosmopolitan; cosmopolitan responsibility is not automatically
given nor guaranteed.38 We agree, and seek to define the idea, extent, and realities of what
global identity and citizenship mean in a way that develops an inter-culturally relevant
neuroethical paradigm that allows particular situational applications without distorting
abstractions. In this light, it is important to consider that identifiable membership in a global
community, that is able to establish at least some grounds for anthropological commonality,
and appreciate bases for anthropological variation, might effectively dilute the conflict
between communitarianism
iii
and cosmopolitanism
iv
, and offers the possibility for the kind of
“fusion of horizons”39 that Dower has referred to as “communitarian cosmopolitanism”.8
Appiah has similarly suggested that the concatenation of both theoretical stances enables an
effective dialectic between the poles of the ‘individual’ and the ‘community’ as bases of
moral cognition and sources of morality, thereby fostering simultaneous commitment to both
the ‘local’ and the ‘universal’ in the development and articulation of ethical precepts and
standards.25
While considering the ‘universal’ pole, the particular ‘version’ of universalism
fostered by an internationally-relevant neuroethics must be characterized, pro Judith
Butler, by a persistent openness to dissent and contingency, and in this way neuroethics
14
remains responsive to contemporary scenarios, and adaptive to future prospects.40 Butler
acknowledges the somewhat paradoxical conditions of universality-in-practice, asserting that
in actuality, any ethical decisions and practices always take place in a “given syntax, through
a certain set of cultural conventions in a recognizable venue”.41 Contradictions often arise,
although (importantly) not in ways or to the extent of being irreconcilable.29 The dialectical
exchange and ‘continuum’
v
from ‘universal’ to ‘local’ or ‘particular’, and the need for
“cultural translation”, implies and compels some form of cross-cultural consensus built upon
dynamic confrontation and negotiation to re-articulate the universal “in the various languages
in which universality makes its varied and contending appearances”.41
So long as the ‘universal’ is not presumed to imply the ‘rigid’, ‘unchanging’, and
‘absolute’, it can enjoy objective validity where and how it achieves recognition and respect
by the people that it purports to burden with its principled norms. Universality need only
point to shared commonality at some point in time, not generic tyranny over all times.
Neither the neurosciences nor empirical inquiry guarantee anything like absolutes; why
should ethics, and/or especially a neuroethics provide such a guarantee? The universal, in this
sense, may become somewhat different in the future, because neither individuals nor peoples
quite stay the same over long stretches of time. The normatively universal should appeal to
what people want to become, as much as what they already are. No community, whatever its
size, is really static, regardless of whether a tradition wishes it were so.
Taking a close interest in global commonality and even global community is not the
same as focusing solely on global citizenship. Perhaps ‘citizenship’ is too rigid a political and
legal construct to fully address and serve here. Advocates of an extant global citizenship8,9 as
prefatory to an internationally-relevant ethics can typically admit that conceptually strict
analogy to ordinary citizenship is both impossible and unproductive. Acknowledgement of
both actively divisive socio-cultural and political structures, and conversely, of structures that
15
institutionalize ‘humanity as a whole’ (e.g. international human rights) fall short as well.
The existence of a ‘global’ community as a social reality, with inter-dependence, shared
traditions and norms, and some degree of loyalty to the whole can be emergently
identified so long as, at least in principle, 1) all humans display – and acknowledge -
aspects of bio-psychosocial commonality and variability; 2) humans have come to
occupy available ecological niches and the position of bio-ecological dominance and
dominion;42 3) each person has some duties towards their social in-groups and potentially
all other people, and 4) individuals can efficaciously engage in actions that may make a
difference at a global level only in the name of a global responsibility.8 A limited
conception of global citizenship could track these crucial factors en route to global
responsibility, which would be ultimately fulfilled through the participation of economic
and political institutions. Philosopher Stan Van Hooft has enumerated basic
responsibilities of global citizenship to (ideally) include: 1) helping each other, 2)
granting cultural respect and political equality across ethnic differences and state borders,
3) affording rights to fair distribution of social goods in a globalized economy, and 4)
active engagement in global and globally-supportive local/national political institutions.
In line with the aforementioned considerations, tensions between the “local” and
“global” may be surmountable through humanity’s growing a kind of identity that has
been labeled as the possession of “multiple-situated selves”.43 Various communities are
simultaneously engaged in differing degrees of social aggregation, so that “the global
sphere is not a domain in itself, separate from other specific domains. It includes them
all, and at the same time manifests itself in each”.21 We should indeed hold off a
misguided search for a separate global way of being human. Yet, we persist in our
assertion that an integrative synthesis is still viable. Solomon Benatar,44 for example,
articulates a conception of a “reasoned, contextual universalism”, taking into account
16
morally relevant local factors conditioning peoples’ interpretation of theoretical universal
concepts within the reality of a specific environment. Thus, the locally contextual application
of some universal set of ethical precepts and parameters becomes practicable because of its
openness to, and respect for the ethos and mores of all agents involved.44
The definition and implementation of an internationally-relevant neuroethics requires a
trans-disciplinary orientation embracing a wide range of methods, knowledge, and
techniques. This approach mandates a critical assessment ofcurrent neuroscientific
knowledge and capabilities, that is yoked to a receptivity and sensitivity to contextual factors,
an ability to examine both individual cultural traditions, andan appreciation for the construct
and effect of culture writ-large (i.e. Kultur). Appiah’s theory of “rooted or partial
cosmopolitanism” supports the possibility of fruitful engagement and harmonization of
universal and local perspectives. Specifically, in a social reality dominated by multiple and
increasing affiliations, an authentic commitment to the ‘local’ must simultaneously generate
an obligation to the ‘universal’.45 Appiah endorses a version of cosmopolitanism that
acknowledges allegiance and loyalty to other forms of social affiliation. For example, a
nation represents an appropriate object of moral commitment as an “imagined community of
culture or ancestry running beyond the scale of the face-to-face and seeking political
expression”.25 A nation, according to this understanding, traditionally hosts ethnic, religious,
and cultural variety, and exemplifies a collective ambition giving rise to its political
community regulated by conventionally normative rules.
Recent discussions about cosmopolitanism25,46-50 call attention to multiple implications
and important critiques. Unmistakably, cosmopolitanism has been impugned as unrealistic; a
dangerous illusion based upon false claims of an existing or potential global identity that
neglects the situated and communitarian bonds of each individual.
vi
;51 Benjamin Barber has
asserted that intellectual conviction (in the Kantian sense of “pure reason”) is the only source
17
of commitment within cosmopolitanism.52 Michael McConnell directs attention to the
risk of moralism and intolerance implied by cosmopolitanism; in his words, the
‘moralistic cosmopolitan’ is one who feels ‘superior’ everywhere.53 This directly recalls
the looming risk of Western philosophical dominance, and resulting tensions and
conflicts that could occur as a consequence (enacted, for example, under a rubric of what
Michel Foucault54 referred to as biopower and biopolitics).
vii
The international pace and trajectories of neuroscientific and technological
advancements surely reconfirm, as we have claimed, the need to consider necessities and
realities of international neuroethics. Yet, authentic attempts toward this goal must
recognize the potential for “moral absolutism” incurred through imperialist enforcement
of Western precepts and standards upon other groups with dissimilar needs and values, as
well as the uncritical “moral relativism” that Nussbaum calls “political cowardice”.29
However, it is noteworthy for us that Barber’s, Himmelfarb’s and McConnell’s stances
on moral cosmopolitanism are all informed by a conceptualization of ethics as concentric
circles of moral concern (family, community, neighborhood, nation, humanity) with the
individual at the center.
VIII. TOWARD A COMMUNITARIAN, COSMOPOLITAN NEUROETHICS
An ecological approach to human capacities and conduct situates each human being as an
individual-in-community. This approach therefore emphasizes the development and
enactment of cognitions, emotions, and behaviors that people must rely upon to live in
society, and hence they must (at least implicitly) accept the opportunity – and challenge –to
respect, share, and adopt social norms and rules. From this agreeably cosmopolitan
perspective, all humans should be included in the concept of society, and thus bear various
levels of responsibility for their individual, group, and communal actions.8 Such
responsibility is supported by recognition of a spectrum of potential interpretations of “the
18
good” as based upon needs, values, and desires. However, ethical views and relations exist
only within the frame of historicized cultural particularities,55 and the moral motivations of
individuals largely reflect and respond to the shared values and social sanctions around
them.8 What does this portend for a realistic framework and practical application of a
cosmopolitan neuroethics?
The relevance of the ‘contingent’ in the definition, assertion, and assessment of social
identities and moral values
viii
is traditionally emphasized by communitarian ethical theories.
Communitarianism comports well with, and supports, both the idea of living in community as
motivation for moral agency, and the importance of social decision-making as the sole source
for practicable ethical solutions.8,56 It is upon these premises that an assimilation between
cosmopolitan and communitarianism, which Dower qualifies as ‘communitarian
cosmopolitanism’, can be established. Communitarian cosmopolitanism begins from the
groundwork of universal ethical claims that are integrated with communitarian accents as
necessary to counterbalance and contextualize large-scale moral concepts.
Dower not only considers the process of communal definition of social values as their
only legitimate matrix, but also focuses attention on widening spheres of social participation,
from which build deepening cosmopolitan obligations.8 Such a complementarity is illustrated
by philosopher F. H. Bradley’s metaphor of morality57 as being endowed with both “body and
soul”; the ‘body’ consists of the social institutions that channel social practices, and the ‘soul’
consists of the individual moral agents keeping the body alive. John Dewey upheld a
similarly organic conception of social institutions as simultaneously guiding, and energized
by, the civic habits of community members.58 Pushing these analogies still further, if we seek
internationally meaningful moral principles, cosmopolitanism provides the soul of that
morality, while communitarianism offers “the insight as to what must also exist for that
morality to be embodied”.8 A society or sub-culture need not be the final sphere of moral duty
19
for a society’s members who can grasp how the many consequences of their joint
conduct, and hence their ethical responsibilities, transcend local contexts towards a
global context. Local institutions (regardless of traditional function) can be adjusted and
coordinated internationally to effect global goals as well as local ends. That opportunity,
if and when realized, affords the capacity to develop wide-ranging ethical concepts that
still remain (narrowly) conceptualized within particular social contexts.
We believe that the core theoretical characteristics that can establish neuroethics as
tenable within international contexts have been successfully identified.6,27,30 Grounded by
a moderate empirical naturalism, the perspective of an alternative meta-ethics for
neuroethics has been outlined as informed by the behavioral and brain sciences.13, 17 We
urge that the translation of such a heuristic model into practice requires a theoretical
methodology that can successfully act at the level of cross-cultural dialectic, local in
origin yet potentially universal, so as to orient the necessary first steps of a reasonable
internationally applicable neuroethics.
IX. A RAWLSIAN APPROACH TO STRUCTURE
A Rawlsian approach could support this dialectical neuroethics within an
internationally multi-dimensional framework. Rawls’conception of ‘reflective
equilibrium’ offers a method for “considered moral judgments”resulting from procedural
reflection on relevant circumstances and contexts, and contingencies of application.The
dynamic interchange between general principles and specific judgments, involving
ongoing modifications to both poles, can result in a “reflective equilibrium” - settling
upon certain ethical priorities in light of known facts. This procedure of reflective
interchange should interest neuroethics, for it must conjoin its tentative ethical priorities
20
to current information from neuroscience and neurotechnology, as well as from historical
experience about ways that past technologies have been both used and misused.
More specifically, neuroethical theorizing appreciates 1) the role for neuroscience as an
objective collection of information, tools, and capabilities; 2) the relatively subjective
meanings and employments of neuroscientific information and techniques in various socio-
cultural settings; and 3) the potential ways for neuroS/T to exert socio-cultural influence, and
be affected in turn by cultural forces (inclusive of individual and community needs, desires,
economics, and politics).15,18,31,32,37 By addressing what Rawls28 described as “background
theories”– that is, a “theory of persons” and a “theory of the role of morality in society” – a
narrower,local perspective can be extended to a wide (and potentially international) reflective
equilibrium for neuroethical conclusions. That equilibrium is just that, a temporary stability
that allows for potential re-engagement, modification, or revision of extant principles based
upon both particularities of circumstance and iteratively newer knowledge. A tentative set of
principles can be employed and then re-balanced to better meet changing conditions within
given communities (of various dimensions) when attempting to address, engage, and resolve
neuroethical problems. It allows for the development a common set of core neuroethical
concepts that can – and should – be utilized with specificity relative to the stake - and
shareholders involved, who can then reflect on acquired practical experience and participate
in periodic ethical reflections as needed into the future.
We are quite aware how circularity has been charged against the Rawlsian approach.
Haslett59 has, for example, claimed that the Rawlsian method is incapable of providing the
criteria necessary to enable choice between apparently incommensurable perspectives; unable
to provide any real justification to rational decision-making; and merely offering “layers of
protection against any possible refutation”. Perhaps Rawlsian ideas seem inadequate to those
seeking more rigid or idealistic absolutes. However, we admire the flexibility of procedures
21
of reflective equilibrium to construct and sustain a consensus on ethical principles
conceptualized only within given contexts – the sort of revisable consensus consistent
with the ecological and pragmatic approach to neuroethics outlined here.
Avoiding the lure of non-revisable absolutes can prevent ethical imperialism, but
varieties of relativism still beckon. What is deemed “right and good” in one socio-
cultural context will not necessarily comport, in each and every aspect, with another. Is
ethics itself irretrievably divided? The inspiring answer, inspired by Dewey and Rawls, is
to rise to a higher reflective level upon ethics itself. Why would ethics, the opportunity to
reflect on all moral values, fail to reflect upon itself? Such failure of reflection gives rise
to many absolutes, as history proves when each culture deems its own ethics entirely
sufficient for all; so, a meta-ethical climb must reach for the local and universal in a
single grasp. A limited and revisable, yet broadly applicable, ethics can be both
procedural and principled without tyrannically overriding all local norms. In particular,
neuroethics can attain a meta-ethical level due to its naturally ecological grounding, and
its emphasis upon neurocentric criteria for moral, ethical, and socio-legal consideration
and treatment.13,14,16,17,42 This neurocentrism yields a “first principle” recommending
dutiful moral regard and care for all creatures enjoying sentience (i.e.-the sentient) and
feeling pain (i.e.- the painient). The prescriptive ordering and application of other, more
specific principles falls to those people who will responsibly employ neuroS/T to their
particular needs, as individuals who are citizens of both local and global communities,
but only insofar as not violating other principles at-large.17
The strength of a Rawlsian perspective to this principled, cosmopolitan neuroethics
is that, rather than simply attempting to provide principled resolutions a priori, it offers a
methodology to explore new questions – and develop potential resolutions - in light of 1)
historicized investigation (i.e.- casuistry), 2) pragmatic evaluation of facts, circumstance
22
and variables; 3) address of meanings and effects of neuroscientific techniques and
technologies within specified contexts, and 4) modeling of outcomes on a variety of scales
and levels. In so doing, it enables a set of core values (i.e.-regard for the sentient and
painient) as universals, but not in ways that are imperialist in philosophical view or posture,
together with stance of flexibility, relevance (although not laissez-faire relativism), and
preparedness for changing epistemological capital, technological capability, and socio-
cultural effect, attitudes, and responses.
X. CONCLUSIONS
Our neuroethical exploration has found several crucial allies along the way. William
Casebeer60 has argued that neuroethics should prioritize three C’s: consent (if, how, and why
individuals and groups agree to the use of neuroscience and its technologies to affect their
lives); consequence (effects and ramifications that use of neuroS/T will have at a variety of
scales and timeframes); and character (articulations and effects of neuroS/T will have upon
the nature and definition of what individuals and groups hold to be of worth and/or “good”).
We agree, adding some grounding meta-ethical C’s in concurrence. Neuroethics should
include a cosmopolitan worldview; the “global” as naturally comprised of both bio-
psychosocial commonalities and differences that are reflected in various philosophies and
perspectives. That worldview then enables contextuality to account and allow for the specific
ways that these similarities and distinctions are manifest in communitarian settings.
In this way, neuroethics will remain discursive and dialectical. It will display the
openness of a moderate cosmopolitan perspective in establishing a basic deontology.
ix
It will
duly regard the peculiar needs, values, and contingencies of individuals and groups. It will
therefore consolidate this global presence within the realities of communitarian affiliation(s),
so as to focus upon the contingencies of humans-in-community – on a variety of
23
levels.
x
;18,31,32,33,61 This neuroethics is poised to achieve, in Rawls’ words, the transition
to an internationally viable modus vivendi
xi
and as such will remain a work-in progress.
ACKNOWLEDGMENTS
This work was supported, in part by funding from the Graduate Liberal Studies Program of
Georgetown University (EL), by the William H. and Ruth Crane Schaefer Endowment, a
Clark Foundation award (Human Science Center, Ludwigs-MaximiliansUniversität,
München, GER), and funds from the Neuroethics Studies Program of the Edmund D.
Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center,
Washington, DC, USA (JG).
NOTES
i
The concept of common morality here adopted corresponds to Kuczewki’s definition as “the conditions for
shared pursuit of the good or as the values, deliberations, traditions, and common construction of the narrative
of a people.” In: Kuczewski MG. The common morality in communitarian thought: reflective consensus in
public policy. Theoret Med Bioethics. 2009; 30(45):45-54. For additional views, see the work of Bernard Gert,
for example: Gert B, Culver C, Clouser D. Bioethics: A return to fundamentals. NY: Oxford University Press;
1997.
ii
Toope argues that an average 7 years-time frame is required to implement the recommendations of a Royal
Commission in the United Kingdom, and a 15-20 year timeframe is needed to work recent scientific findings
into operative policy.
iii
Communitarianism theorizes that the individual is nested in, and determined by a relational system of social
and cultural inter-dependence. Social order rests on peoples’ inter-dependence, and society only functions if
people recognize and act upon their communal responsibilities. If on one hand cooperation is necessary to the
state’s functioning, on the other hand, the state’s effectiveness is necessary to individuals’ survival. The
community’s social functions are the fundamental source of morality, meaning that the community has
ontological priority in regard to human flourishing. The ‘common good’ is indeed privileged, although from this
notion many variations of communitarianism arise. For example, East Asian communitarian theories generally
stress the role of community and authority, reducing the individual to a cell of this encompassing whole, while
other, more Western forms focus on individual relevance within a conception of a “socially embedded self”.
iv
All cosmopolitan conceptions of morality emphasize the equal stature of all human beings’ moral worth, so
that all deserve equal consideration and involvement in the decisions (particularly those concerning law- and
policy-making) affecting their fundamental interests, and share corresponding reciprocal responsibilities. As
Thomas Pogge further specifies, this conception of the individual human being as the ultimate unit of moral
concern includes both an interpersonal ethical cosmopolitanism (specifically interesting human conduct) and its
international version (ethics as applied to international dynamics and states’ conduct). In: Pogge T.
Cosmopolitanism and sovereignty. Ethics, 1992; 103(1):48-75.
24
v
The dynamic interaction between ‘universal’ and ‘local’ suggested here is inspired by the concept of
hermeneutical circularity anticipated by Nietzsche in the theme of "Eternal Return.” Hermeneutical circularity is
the process of dialogical circulation that continually resists reducing one pole of any relational structure to its
oppositional other. The question that originates true dialogue is kept alive by working to enact the conditions,
both intellectual and social, necessary to render the circulation sustainable.
vi
“What cosmopolitanism obscures, at least to some extent in more assertive forms, are the givens of life:
parents, ancestors, family, race, religion, heritage, history, culture, tradition, community – and nationality. These
are not ‘accidental’ attributes of the individual”, but rather are imperative for any real consideration of the ways
that bio-psychosocial humans are participatory in the world. In: Himmelfarb G. The illusions of
cosmopolitanism. In: Van Hooft, S. (Editor). Cosmopolitanism: A philosophy for global ethics. Durham:
Acumen; 1996.
vii
For excellent discussion of potential biopolitical use of neuroscience, and related neuroethical concerns, see
Thomsen K; In: Giordano J (Editor). Neurotechnology in national security: Practical considerations,
neuroethical concerns. Boca Raton, CRC. In press 2014.
viii
A fundamental difference between cosmopolitanism and communitarianism concerns the origin of human
values: for cosmopolitan theories, human beings are bearers of the values, and thus they generate duties as
human beings in relation to one another; communitarianism affirms socially-constituted values, thus binding in
the name of and strictly within meaningful relations. A relation should be considered meaningful if informed, in
Dower’s words, by sentiment, affection, shared traditions, convention, reciprocity, and contract. In: Dower N.
World ethics. The new agenda. 2nd ed. Edinburgh: Edinburg University Press; 2007.
ix
This set of duties posits adherence to a naturalistic basis, need for pragmatic evaluation and incorporation of
current facts relevant to neuroscience and the neurobio-psychosocial nature of embodied organisms embedded
in ecologies, and necessitates an ongoing self-critical and self-revising approach.
x
In so doing, this approach comports well with other ethical systems, such as consequentialism (which
emphasize utility, non-obsolescence), and agent/actor-based approaches (that place considerable value upon
individual intellectual and moral virtues and attributes, inclusive of autonomy, creativity, and the role of the
individual within a group or polis, e.g.- citizenship; see Shook and Giordano17 for detailed discussion).
xi
Rawls defines his idea of ‘modus vivendi’ through an example that involves two countries with conflicting
interests and traditionally open to pursue their goals at the expense of their competitors but still motivated by
virtue of their national interests to negotiate a treaty. The equilibrium of the agreement will lie in the fact that
both publically acknowledge that a violation of the treaty concerned will negatively impact their national
interest. In this perspective, “social unity is only apparent as its stability is contingent on circumstances
remaining such as not to upset the fortunate convergence of interests”. In: Rawls J. The idea of an overlapping
consensus. Oxford J Legal Studies, 1987;7(1): 1-25.
REFERENCES
1. Giordano J. The human prospect(s) of neuroscience and neurotechnology: Domains of
influence and the necessity – and questions - of neuroethics. Hum Prospect. 2014; 5(1):
1-19.
2. Lynch Z, McCann CM. Neurotech clusters 2010: Leading regions in the global
neurotechnology industry 2010-2020. NeuroInsights Report, 2009. Accessed online at:
http//www.neuroinsights.com. [29. Dec 2013].
3. Sobocki P, Lekander S, Berwick J, Oleson J, Jönsson B. Resource allocation to brain
research in Europe- a full report. Eur J Neurosci 2006; 24(10):1-24.
4. Brindley T, Giordano J. International standards for intellectual property protection of
neuroscience and neurotechnology: Neuroethical, legal and social (NELS) considerations
in light of globalization. Stanford J Law Sci Policy. 2014 (in press)
5. Roskies A. Neuroethics for the new millenium. Neuron. 2002; 35:21-23.
25
6. Racine E. Pragmatic neuroethics: Improving treatment and understanding of the mind-
brain. Cambridge: MIT Press; 2010.
7. Giordano J, Olds J. On the interfluence of neuroscience, neuroethics and legal and social
issues: The need for (N)ELSI. AJOB-Neurosci. 2010; 2(2):13-15.
8. Dower N. World ethics. The new agenda. 2nd ed. Edinburgh: Edinburg University Press;
2007.
9. Van Hooft S. Cosmopolitanism: a philosophy for global bioethics. Montreal and
Kingston: McGill-Queen’s University Press; 2009.
10. Beauchamp TL, Childress JF. Principles of biomedical ethics. 5th ed. NY: Oxford
University Press; 2001.
11. Giordano J, Gordin B. Scientific and philosophical perspectives in neuroethics.
Cambridge: Cambridge University Press; 2010.
12. Giordano J, Forsythe C, Olds J. Neuroscience, neurotechnology and national security:
The need for preparedness and an ethics of responsible action. AJOB-Neurosci. 2010;
1(2):1-3.
13. Giordano J. Neuroethics: interacting “traditions” as a viable meta-ethics. AJOB
Neurosci. 2011; 2(2):17-19.
14. Giordano J. Neuroethics: traditions, tasks and values. Hum Prospect. 2011;1(1):4-8.
15. Giordano J, Benedikter R. Neurotechnology, culture and the need for a cosmopolitan
neuroethics. In: Giordano J (Editor). Neurotechnology: premises, potential and problems.
Boca Raton: CRC Press. 2012; 233-242.
16. Giordano J, Benedikter R, Kohls N. Neuroscience and the importance of a
neurobioethics: A reflection upon Fritz Jahr. In: Muzur A, Sass HM (Editors). Fritz Jahr
and the foundations of integrative bioethics. Münster; Berlin: LIT Verlag; 2012.p. 65-80.
17. Shook JR, Giordano J. A principled and cosmopolitan neuroethics: considerations for
international relevance. Phil Ethics Hum Med. In press 2014;9.
18. Giordano J, Benedikter R. An early - and necessary - flight of the Owl of Minerva:
Neuroscience, neurotechnology, human socio-cultural boundaries, and the importance of
neuroethics. J. Evol Technol. 2012:22(1):14-25.
19. Justo L, Erazun F. Neuroethics needs an international human rights international frame.
AJOB Neuroscience. 2010; 1(4):17-18.
20. Toope S. Internationalism and global norms for neuroethics. American Journal of
Bioethics. 2009;9(12).
21. Ten Have HA. Global bioethics and communitarianism. Theor Med Bioeth. 2011;
32:315-326.
22. Hols S, Williams-Jones B. Global bioethics: myth or reality? BMC Med Ethics. 2006;
7:10.
23. Lombera S, Illes J. The international dimensions of neuroethics. Dev World Bioethics,
2009; 9:57-64.
24. Ridley M. Nature via nurture. New York: Harper-Collins; 2003.
25. Appiah KA. Cosmopolitanism: ethics in a world of strangers. New York: Norton; 2006.
26. Jahr F. Bio-Ethik: Eine Umschau über die ethischen Beziehungen des Menschen zu Tier
und Pflanze. Kosmos. Handweiser für Naturfreunde. 1927;24(1):2-4.
26
27. Levy N. Neuroethics: A new way of doing ethics. AJOB-Neurosci. 2011; 2(2):3-9.
28. Rawls J. A theory of justice. Cambridge MA: The Belknap Press; 1971.
29. MacKenzie J. Refiguring universalism. Martha Nussbaum and Judith Butler – An uneasy
alliance? Austral Fem Studies. 2009; 24:61.
30. Levy N. Introducing neuroethics. Neuroethics. 2008; 1:1-8.
31. Giordano J. Neurotechnology as demiurgical force: Avoiding Icarus’ folly. In: Giordano,
J. (Editor). Neurotechnology: Premises, potential and problems. Boca Raton: CRC Press;
2012, p. 1-14.
32. Giordano J. Integrative convergence in neuroscience: trajectories, problems and the need
for a progressive neurobioethics. In: Vaseashta A, Braman E, Sussman P (Editors).
Technological innovation in sensing and detecting chemical, biological, radiological,
nuclear threats and ecological terrorism. (NATO Science for Peace and Security Series),
New York: Springer; 2012, p. 219-230.
33. Giordano J, Benedikter R. Neurotechnology, culture and the need for a cosmopolitan
neuroethics. In: Giordano J, (Editor), Neurotechnology: Premises, potential and
problems. Boca Raton: CRC Press; 2012, p.233-242.
34. Potter VR. Global bioethics: building on the Leopold legacy. East Lansing: Michigan
State University Press; 1988.
35. Moreno J. Bioethics is naturalism. In: McGee G (Editor). Pragmatic bioethics. Nashville:
Vanderbilt University Press; 1999.
36. Khushf G. The ethics of NBIC convergence. J Med Phil. 2007; 32(3):185-196.
37. Giordano J. Keeping science and technology education In-STEP with the realities of the
world stage: Inculcating responsibility for the power of STEM. Synesis: J Sci, Technol,
Ethics Policy. 2012; 3(1):G1-5.
38. Beck U. Cosmopolitan realism: on the distinction between cosmopolitanism in
philosophy and the social sciences. Global Networks. 2004; 4(2):131-146.
39. Gadamer HG. Truth and method. 2nd ed. London: Sheed and Ward; 1989.
40. Butler J. Contingent foundations: feminism and the question of ‘postmodernism’. In:
Benhabib S, Butler J, Cornell D, Fraser N. (editors). Feminist contentions: A
philosophical exchange, NY: Routledge; 1995.
41. Butler J. Restaging the universal: hegemony and the limits of formalism. In: Butler J,
Laclau E, Žižek S (Editors). Contingency, hegemony, universality: contemporary
dialogues on the left. NY: Verso; 2000.
42. Loveless S, Giordano J. Neuroethics, painience and neurocentric criteria for the moral
treatment of animals. Camb Q Healthcare Ethics. In press 2014.
43. Sandel MJ. Democracy’s discontent: America in search of a public philosophy.
Cambridge: Belknap Press; 1996.
44. Benatar SR. Towards progress in resolving dilemmas in international research ethics. J of
Law, Med Ethics. 2004; 32(4):574-82.
45. Freedman M. The ethics of identity: A rooted cosmopolitan. The New York Times. Jun
12, 2005 [cited Oct 5, 2013]:
http://www.nytimes.com/2005/06/12/books/review/12FREEDMA.html?pagewanted=all
&_r=0.
27
46. Bernstein A. Moral cosmopolitanism. In: Encyclopedia of global justice. NY: Springer;
2012.
47. Beitz C. Political theory and international relations. 2nd ed. Princeton: Princeton
University Press; 1999.
48. Moellendorf D. Cosmopolitan justice. Boulder: Westview Press: 2002.
49. Pogge T. Cosmopolitanism and sovereignty. Ethics, 1992; 103(1):48-75.
50. Singer P. One world: the ethics of globalization. 2nd ed. New Haven: Yale University
Press; 2004.
51. Himmelfarb G. The illusions of cosmopolitanism. In: Van Hooft S (Editor).
Cosmopolitanism: a philosophy for global ethics. Durham: Acumen; 2006.
52. Barber BR. Constitutional faith. In: Van Hooft S (Editor). Cosmopolitanism: A
philosophy for global ethics, Durham: Acumen; 2009.
53. McConnell MC. Don’t neglect the little platoons. In: Van Hooft S (Editor).
Cosmopolitanism: a philosophy for global ethics. Durham: Acumen, 2009.
54. Foucault M. The birth of the clinic: An archaeology of medical perception. NY: Vintage
Press; 1973.
55. Benedikter R, Giordano J. Neurotechnology: new frontiers for European policy.
Paneuropean network: science and technology. Eur J Government. 2012;1(3):204-208.
56. Kuczewski MG. The common morality in communitarian thought: reflective consensus
in public policy. Theoret Med Bioethics. 2009; 30(45):45-54.
57. Bradley FH. Ethical studies. Oxford: Oxford University Press; 1878.
58. Dewey J, Tufts JH. Ethics. 2nd ed. New York: Henry Holt; 1932.
59. Haslett DW. What is wrong with reflective equilibria? Philos Quarterly. 1987;
37(148):305-311.
60. Casebeer W. Plenary testimonial presented at US’ President’s Commission for the Study
of Bioethical Issues. Aug 23, 2013. www.bioethics.gov/node/2224.
61. Ambrosio FJ. Philosophy, religion and the meaning of life. Chantilly: The Teaching
Company; 2009.
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Table I.
Neuroscientific/Neurotechnological
(NeuroS/T) Developments
Neuroethical Issues
I. Use of neuroS/T to assess physiology,
cognition, emotion, and behavior
NeuroS/T approaches include:
Neuroimaging
– PET
– SPECT
– fMRI
– fNIRS
– DTI
– qEEG
– MEG
Neurogenomics/genetics
Neuroproteomics
Neurobiomarker assessment
Validity, viability, and value of
neuroS/T capability, assessment,
claims and meanings
Imposition upon privacy and
personal liberty
Use/misuse of neurocentric criteria
to define/predict:
– Personhood
– Capability
– Culpability
– Normality/abnormality
– Potential
Use of neurocentric criteria to
establish social norms and
standards for socio-economic and
political treatment
II. Use of neuroS/T to affect brain
structure and functions (cognition,
emotion, and behavior)
NeuroS/T approaches include:
Tissue and genetic manipulation, e.g.:
– Transplants
– Stem cells
– Genomic/genetic modification
Neuro-psychotropic drugs (to affect
memory, vigilance, sleep, pain, mood,
aggression, etc.)
Neural-machine interfaces, e.g.:
– Neuroprosthetics
– Deep-brain stimulation
– Direct cortical stimulation
– Transcranial stimulation
– Neurofeedback
Actual capabilities and limitations
Appreciation/recognition and
responsibility for benefits, burdens,
risks, and harms.
Defining nature and extent of
treatment, enablement, and
enhancement
Thought, emotion, personality, and
behavioral alteration and control
Weaponization of neuroS/T
Technical and economic leveraging
to affect political (bio)power
Distributional variation (i.e.,
influencing social status of
neurocentrically-determined “haves
and have-nots”)
29
III. Reverse engineering neural
systems/brains
NeuroS/T approaches include:
Decision-making neurotechnical
systems
Sentient machine systems
Need for novel ethico-legal
considerations
– Neuro-roboethics
Loss of human capability/control
– “Techno-dementia”
– “Machine citizens”
Abbreviations: PET: positron emission tomography; SPECT: single photon emission computed
tomography; fMRI: functional magnetic resonance imaging; fNIRS: functional near infrared
spectroscopy; DTI: diffusion tensor imaging; qEEG: quantitative electroencephalography;
MEG: magneto-encephalography
