ArticleLiterature Review

Toward an Operational Neuroethical Risk Analysis and Mitigation Paradigm for Emerging Neuroscience and Technology (NeuroS/T)

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Abstract

Research in neuroscience and neurotechnology (neuroS/T) is progressing at a rapid pace with translational applications both in medicine, and more widely in the social milieu. Current and projected neuroS/T research and its applications evoke a number of neuroethicolegal and social issues (NELSI). This paper defines inherent and derivative NELSI of current and near-term neuroS/T development and engagement, and provides an overview of our group's ongoing work to develop a systematized approach to their address. Our proposed operational neuroethical risk assessment and mitigation paradigm (ONRAMP) is presented, which entails querying, framing, and modeling patterns and trajectories of neuroS/T research and translational uses, and the NELSI generated by such advancements and their applications. Extant ethical methods are addressed, with suggestion toward possible revision or re-formulation to meet the needs and exigencies fostered by neuroS/T and resultant NELSI in multi-cultural contexts. The relevance and importance of multi-disciplinary expertise in focusing upon NELSI is discussed, and the need for neuroethics education toward cultivating such a cadre of expertise is emphasized.

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... xii) still remains incompletely answered. On a practical level, this evokes an intersection of unknowns: what is unknown about causality in the brain, and what is unknown about the way new techniques and technologies may affect such processes and their manifestations, especially beyond the short term, which both evokes further NELSI (as related to veridicality of information and informed consent), and fortifies the need to iteratively address such issues, questions, and problems (Giordano, 2012(Giordano, , 2015(Giordano, , 2017. To date, tES has been used to improve cognitive and motor function of patients with Parkinson's Disease Fregni et al., 2006;Pereira et al., 2013); elevate mood of patients with depression (Nitsche, Boggio, Fregni, & Pascual-Leone, 2009); improve performance in tasks of attention, learning, memory (Coffman, Clark, & Parasuraman, 2014), and verbal fluency (Pisoni et al., 2017); and reduce certain forms of performance-related anxiety in healthy subjects (Sarkar, Dowker, & Cohen-Kadosh, 2014). ...
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Article
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... We have proposed a risk assessment approach to more specifically define and address the issues, questions and problems generated by possible uses of emerging neuroscientific and neurotechnological developments (386,387); but address does not assure resolution. While some concerns relate to safety and effectiveness (e.g., possibilities of unanticipated consequences, runaway effects) with regard for patients' welfare (i.e., via integrity of informed consent and availability of sustainable clinical care), others reflect recognition of problematic distribution of medical goods [for overview, see (388)]. ...
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Central neurotrauma, such as spinal cord injury or traumatic brain injury, can damage critical axonal pathways and neurons and lead to partial to complete loss of neural function that is difficult to address in the mature central nervous system. Improvement and innovation in the development, manufacture, and delivery of stem-cell based therapies, as well as the continued exploration of newer forms of stem cells, have allowed the professional and public spheres to resolve technical and ethical questions that previously hindered stem cell research for central nervous system injury. Recent in vitro and in vivo models have demonstrated the potential that reprogrammed autologous stem cells, in particular, have to restore functionality and induce regeneration—while potentially mitigating technical issues of immunogenicity, rejection, and ethical issues of embryonic derivation. These newer stem-cell based approaches are not, however, without concerns and problems of safety, efficacy, use and distribution. This review is an assessment of the current state of the science, the potential solutions that have been and are currently being explored, and the problems and questions that arise from what appears to be a promising way forward (i.e., autologous stem cell-based therapies)—for the purpose of advancing the research for much-needed therapeutic interventions for central neurotrauma.
... Research neuroethics takes the research context and the methodical work of researchers as its field for targeted inquiries. For some novel application of neuroscience and its technologies (i.e., neuroS/T), the development and availability of neuroS/T research can be queried and assessed at many levels (Giordano 2015(Giordano , 2016. These levels include a range of questions about research ethics: ...
Chapter
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... Moreover, DBS research and clinical use are becoming ever more international, as several countries are dedicating considerable financial resources to large-scale neuroscientific and neurotechnological initiatives. The field is collaborative and competitive; and both collaboration and competition can evoke asymmetries in technological capability, focus and scope of research, and provision and access to interventions (Martin et al., 2016;Becker et al., 2017;Giordano, 2017). These asymmetries can-and likely will-occur both within nations (e.g., as reflective of differing economics, insurance coverage, etc.,), and between nations (i.e., in light of distinct cultures' economies, norms, and values, philosophies, ethics, and laws). ...
Article
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The unknowns of the brain-mind relationship and the novelty of neurologic techniques and technologies give rise to ethical questions that can be described, analyzed, and answered using a preparatory neuroethical framework to mitigate potential problems.
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The geopolitical landscape of the 21st century is more complex, dynamic, and unpredictable than that faced in the previous century. Making strategic decisions are complex and involve socio-economic, geo-political, techno-economic, forward-thinking and paradigm-shifting considerations to support policy and investment decisions to address global challenges. We posit advanced sciences convergence (ASC) as a decision support methodology supporting the early identification of emerging issues that will have an impact on international policies. The convergence of multiple disciplines creates a synergy capable of overcoming persistent barriers by mapping knowledge gaps. Prudent convergence methodologies inculcate, conceive and advance transformational, revolutionary, and embryonic opportunities allowing for next generation solutions to current and future societal and technical challenges. A “framework by design” of emerging scientific and technological advances and trends is developed through a systematic and strategic planning process to deepen the understanding of current, future, and varying challenges and opportunities and create fully integrated solution paths to address current and future global issues. Through a systematic introduction of the ASC, the methodology exploits futures-oriented analytical methodologies, including heuristics, data-mining, scientometrics, modelling and simulation, and scenario development to provide solutions and their potential for integrated, novel and/or unconventional manifestations. One of the futures-oriented approaches - TechFARMTM comprises of three overlapping practices of future studies, including: foresight; assessment; and forecasting. The desired outcome of TechFARMTM is to provide a technology roadmap (TRM), assessment of technology readiness level (TRL), and provide continuously evolving decision implementation guidance in a sustained and unified way, expanding awareness of technological options and outcomes. In addition to TechFARMTM, tools and research methodologies such as ADAMSTM and NESTTSTM are introduced to expand the identification of emerging disruptive and futuristic trends in science and technology intelligence (S&TI). The tools and research methodologies include in-depth analysis, using convergence of multi/trans-disciplinary S&T fields, and are focused on nanotechnology, biotechnology, information technology, cognitive sciences, artificial intelligence, robotics, and genetics. This construct presents an exceptional platform for transforming the manner in which state-of-the-art information is gathered, analyzed, and leveraged to enable RM development. The TRM is an evolving concept and is composed of numerous subsystems, with an expectation to minimize the impact of and manage technology uncertainty and surprise through exploiting futures-oriented analytical methods, modelling and simulation, and scenario development. Visionary and unbiased assessment of technology platforms is necessary to facilitate detection of weak signals in consideration of technological innovations, and reveal insight into “system of systems” strengths and weaknesses. As with any emerging scientific and technical advances, there are some ethical considerations with the ASC that should be taken into consideration and are discussed. Keywords: TechFARM, GRAIN, BANG, ADAMS, NESTS, nanotechnology
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The advanced integrative scientific convergence (AISC) model represents a viable approach to neuroscience. Beyond simple multi-disciplinarity, the AISC model unifies constituent scientific and technological fields to foster innovation, invention and new ways of addressing seemingly intractable questions. In this way, AISC can yield novel methods and foster new trajectories of knowledge and discovery, and yield new epistemologies. As stand-alone disciplines, each and all of the constituent fields generate practical and ethical issues, and their convergence may establish a unique set of both potential benefits and problems. To effectively attend to these contingencies requires pragmatic assessment of the actual capabilities and limits of neurofocal AISC, and an openness to what new knowledge and scientific/technological achievements may be produced, and how such outcomes can affect humanity, the human condition, society and the global environment. It is proposed that a progressive neurobioethics may be needed to establish both a meta-ethical framework upon which to structure ethical decisions, and a system and method of ethics that is inclusive, convergent and innovative, and in thus aligned with and meaningful to use of an AISC model in neuroscience.
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New ethical issues arise in the convergence of nanotechnology, biomedicine, information technology, and cognitive science (NBIC). This chapter considers the ethical issues associated with two central features of the NBIC initiative: the accelerating rate of development, and the goal of enhancing human performance. Traditionally, ethical reflection has come only after research and development, and the application of innovations was slow enough that the discussion could be far advanced before their full impact had been felt, but the rapidity of NBIC progress will require ethical reflection at all steps in the process. Many critics and ethicists argue that technology should only return humans to "natural" levels of functioning, rather than give them new or greater capabilities. The Convergence Movement may need to address enhancement directly and make the case for why it could be an ethical goal. The chapter ends with a closing remark on the convergence of the sciences with the humanities.
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The political terrain of the 20th century was shaped by the economic issues of taxation, labor, and social welfare and the cultural issues of race, nationalism, gender, and civil liberties. The political terrain of the 21st century will add a new dimension - technopolitics. At one end of the technopolitical spectrum are the technoconservatives, defending "human dignity" and the environment from technological progress. On the other end of the spectrum are the technoprogressives, holders of the Enlightenment faith that scientific and technological progress is liberating. Some of the key points of conflict in the emerging technopolitical struggle are the bioethical debates over human enhancement technologies. Technoprogressives such as "transhumanists" advocate for the right to use technologies that transcend human limitations, whereas technoconservatives argue for a strict limit on the nontherapeutic uses of biomedicine. Technopolitics has cut across the existing political lines and created odd coalitions between left-wing and right-wing technoconservatives on one side and technolibertarians and technodemocrats on the other. Future technopolitical debates are suggested that will force further technopolitical polarization.
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A historical model of techno-economic change with socio- political adjustments is used to illuminate how neurotechnology will influence human society in the next three decades. The impact of neurotechnology in the financial sector is discussed with an overview of how the European Union and the United States are responding to the political and ethical issues that arise from advanced neurotechnology. The development of neurotechnology, tools that analyze and influence the nervous systems, is being accelerated by the convergence of NBIC technologies and will create new leading neurotech clusters.
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The aim of this article is to argue, by example, for neuroethics as a new way of doing ethics. Rather than simply giving us a new subject matter-the ethical issues arising from neuroscience-to attend to, neuroethics offers us the opportunity to refine the tools we use. Ethicists often need to appeal to the intuitions provoked by consideration of cases to evaluate the permissibility of types of actions; data from the sciences of the mind give us reason to believe that some of these intuitions are less reliable than others. I focus on the doctrine of double effect to illustrate my case, arguing that experimental results suggest that appeal to it might be question-begging. The doctrine of double effect is supposed to show that there is a moral difference between effects that are brought about intentionally and those that are merely foreseen; I argue that the data suggest that we regard some effects as merely foreseen only because we regard bringing them about as permissible. Appeal to the doctrine of double effect therefore cannot establish that there are such moral differences.
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