German Ethics Council's first annual conference held on neuroethics to great public acclaim
More and more insights and potential practical applications are accruing in the neurosciences, with implications that are often difficult to predict in spite - or indeed because - of the promise they are stated to hold out.
As Christiane Woopen, the Council's Deputy Chair, pointed out in her introduction, the matter was especially acute because it not only raised questions within the ethical field, along the same lines as those arising, for instance, in the case of stem cell research, but also touched upon the very foundations and basic principles of ethics itself. She noted that our image of man influenced the way in which we posed ethical questions, the questions that we deemed particularly important, and how we answered them.
Can images of the brain help us to understand our thinking and feeling? Is it acceptable for healthy subjects to take performance-enhancing drugs of the kinds developed for the treatment of mental illness, dementia or attention disorders? What might be the outcome if implanted electrodes could home in ever more closely on, and influence, specific brain functions such as motor activity, speech and mood? These were the three central questions on which the meeting focused.
In her introductory paper, after tracing the historical development of our present-day conceptions of the brain and the associated image of man, the neuropsychiatrist Barbara Wild furnished an overview of the current status of brain research.
The neurobiologist John-Dylan Haynes gave an account of the still young discipline of brain reading, which investigated how far the content of a person's thoughts could be inferred from their cerebral processes. Although it was not yet possible to interpret a given thought or to transfer ideas from one person to another, the simpler approaches already available today held out the prospect of a variety of applications, in particular in the fields of forensics and criminology (e.g. for lie detection) or thought-mediated control of computers and prostheses.
Isabella Heuser, a psychiatrist, reported on the fast-growing trend for healthy subjects to use medication to enhance and augment their cognitive performance. The main preparations concerned were ones developed to treat attention disorders, narcolepsy and the dementias. In her talk she presented the results of research on the effects and side-effects of antidepressants, stimulants and anti-dementia drugs, and outlined the associated ethical problems.
In his lecture, the psychiatrist Thomas Schläpfer said that deep brain stimulation was a highly effective technique for modulating severely disturbed neuronal activity and for the therapy of neurodegenerative and psychiatric disorders that could not be treated by other methods. He emphasized that, unlike the psychosurgery prevalent in the last century, the procedure was minimally invasive, relatively unstressful and completely reversible. This treatment could often put patients back in charge of their lives when all else had failed.
Tade Matthias Spranger, an academic lawyer, pointed out that the ultimate criterion for the evaluation of a method was human dignity, which was an absolute. "Thought reading" by means of imaging techniques in criminal proceedings was not permissible if applied against the will of the subject, because everyone had the right to informational self-determination. On the other hand, there was also the potential for improving the legal situation of, for example, disabled persons, who could take advantage of technology for improved communication of their needs and thereby regain their legal capacity.
In the view of the criminal lawyer Henning Rosenau, brain interventions assumed legal relevance if they affected our image of man and our core conception of what it meant to be human. However, it was unclear whether such interventions in themselves had implications for human dignity and were consequently excluded from the right of disposal of the person concerned. Another question was whether neuro-enhancement carried out for social reasons could be limited by legally unchallengeable arguments.
The philosopher Ludger Honnefelder's contribution centred on the ethical dimension of brain research; he concluded that the issue of neuro-enhancement was discussed primarily in terms of authenticity and the preservation of personal identity in the conduct of an individual's life. Increasing human cognitive capacity was legitimate only if there were a consensus in society on the aims to be thereby achieved.
Wolfgang van den Daele, a sociologist, and Dietmar Mieth, a theologian, took up these ideas in the concluding debate. Professor van den Daele insisted that everyone could and should decide for themselves whether they could continue to lead an authentic life if they availed themselves of neuro-enhancement. Any external judgement was presumptuous.
Mieth, on the other hand, favoured a social debate that would lead to a consensus on what was feasible, permissible and achievable. Although it was ultimately not possible to ban people from manipulating their own brains, legal limits could be set to the development of harmful products and measures, as well as to experiments and applications for the benefit of third parties.
In the three rounds of discussion, the audience showed itself to be predominantly hostile to neuro-enhancement. It was argued in particular that, precisely in an achievement-oriented society, the growing availability of such methods would only increase the pressure on the individual to use them.