Bennett Foddy

Announcement: Welcome to members of the International Neuroethics Society

We are pleased to welcome members of the International Ethics Society (INS), who are collaborating with us on the new Neuroethics blog. The new blog is co-located with our existing practical ethics blog, and all neuroethics articles will be automatically cross-posted between the two. You can access the neuroethics blog by clicking here.

Martha Farah, the Communications and Outreach Chair for the INS, sends the following message to inaugurate the neuroethics blog.

Thank you to Bennett, Julian and the rest of the Practical Ethics Bloggers, from your new partners in neuroethics blogging: the International Neuroethics Society!

For those of you who don’t know about the INS (formerly the NS), we are a group of academics and professionals who together work to support the following mission:

“Our mission is to promote the development and responsible application of neuroscience through interdisciplinary and international research, education, outreach and public engagement for the benefit of people of all nations, ethnicities, and cultures.”

If you are reading this blog, and find the neuroethics postings interesting, then I respectfully submit that you are our kind of person – so please join the Society! Here’s where you can find out more: http://www.neuroethicssociety.org/

To INS members who are reading this, I hope you will consider blogging here whenever you come across a news item, academic publication or talk that raises interesting neuroethical issues. Share your thoughts here, and start a discussion with other members and readers. That way we can learn from each other.

If you’d like to submit to the blog, or have other questions about it, please contact Bennett Foddy, at bennett {dot} foddy {at} philosophy (dot) ox (dot) ac (dot) uk.

–Martha J. Farah, INS Communications and Outreach Chair

Annoucement: Bio-ethics Bites

We are pleased to announce the launch of Bio-ethics Bites, a freely-available series of interviews with leading thinkers on issues in practical ethics. Already posted: an interview with Jeff McMahan (Rutgers) on the question of moral status, and an interview with Julian Savulescu (Oxford) on designer babies.

In the pipeline: interviews with Peter Singer (Princeton), Nick Bostrom (Oxford) and Baroness O’Neill of Bengarve.

Bio-ethics Bites is produced by David Edmonds and Nigel Warburton, and funded by the Wellcome trust.

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The Second Coming of the Placebo Treatment

The German Medical Association has recommended that doctors should sometimes make use of deceptive placebo treatments when those treatments may be more effective than pharmacologically active alternatives. This recommendation stands at odds with the position of nearly every other international medical association, including the British Medical Association and the American Medical Association, which ruled in 2007 that it would always be unethical for doctors to prescribe placebos without informing their patients.

There is a gathering controversy on the placebo issue; for a long time it has been assumed that placebo treatments are both unethical and/or ineffective, and that widespread use of placebo treatments would grievously undermine the trust between doctors and patients. But a series of recent studies has been undermining the orthodox opinion:

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In Brief: New Evidence Shows Expectations Influence Pain

In the current issue of Science Translational Medicine, Oxford neuroscientists in Irene Tracy’s lab have published a new study of the placebo effect with dramatic results.

In their experiment, test subjects were subjected to pain in the form of heat, while inside an fMRI brain imaging machine, and asked to rate their subjective feelings of pain. After the pain was induced, a powerful opiate analgesic drug, remifentanil, was administered by a covert injection, leading the subjects to report a slightly lower level of pain. Next, they were informed that a drug had been given, and their reported pain fell much more. And finally, they were told (falsely) that the drug had been withdrawn, upon which their pain returned to the level it was at before the drug was injected.

The experiment is significant for three reasons: first, it provides the strongest evidence so far that our expectations of benefit significantly contribute to our experience of suffering. Second, it shows that the benefit of a powerful modern painkiller can be completely eradicated if the patient believes she is not getting a drug. And finally, the experiment’s fMRI data showed that the positive effects were associated with the same pattern of brain activation as inert placebos, but that the negative effects were associated with activity in unrelated parts of the brain that are associated with increase in pain due to anxiety. This last point proves that the total elimination of the drug’s effect was not simply due to the removal of the beneficial placebo effect—rather, our minds have the ability to entirely block the beneficial action of a real analgesic drug.

The experiment has deep implications both for the neuroscience of pain and for philosophical questions in phenomenology. But it has immediate implications for the ethics of clinical practice as well. It is essential that we start to understand the power that our expectations have over our experiences. Prescribing a patient a pill for pain is simply not enough on its own; in fact, if the patient expects the pill not to work, it might be better not to prescribe anything at all.

The Ethics of Gamification: Little Rewards for Everything

[note: the original version of this post contained some interactive code, which has been removed from the archives]

Notice that the first word of this post is red. Point your mouse cursor at the words as you read them, and each subsequent word will turn red as you read. You are now being graded on how quickly you read these words. And there’s a little visual reward in store for anyone who reads the first paragraph quickly. Now look to the right of this post, where it says ‘Top Posts’. One of the reasons we have that is to help readers to find the most popular posts on the blog. But another reason we have it is so that our contributors will be motivated to write more interesting and thought-provoking commentaries for the site. It is a high score table, and the winner is the philosopher with the most interesting post.

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Addiction by design

A new report released by the US Surgeon General last month reminds us that cigarettes are designed with addiction in mind. Tobacco companies infuse tobacco with ammonia so that the nicotine crosses the membranes in the lungs faster, reducing the delay between inhalation and pharmacological effect. They add flavourings like chocolate and vanilla to the blend, knowing that smokers will be more likely to smell something in their food that they associate with smoking, and to feel like lighting up. These tricks are a source of moral outrage for many of us; it seems as though the tobacco companies are exploiting weaknesses in our biology to make us buy things we would not otherwise have bought, and to do things we would not otherwise have done (or would not have done so much). And tobacco executives have often denied engaging in these kinds of tactics.

All this makes for an interesting contrast with the case of video games, in which addictiveness is universally held to be one of the hallmarks of an excellent game, in which games can win awards for being addictive, and in which a developer can unabashedly boast of putting the most addictive systems into their games.

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Our Future as Human Lobsters

On Sunday, scientists at the Harvard Dana-Farber Cancer Institute announced that they had succeeded in reversing age-related decline in mice, using genetic engineering techniques. The scientists created transgenic mice with a gene for telomerase expression that could be switched on and off with a chemical signal.

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Counterfeit Placebos

Last week it was reported that police in Bangladesh had made a major bust at a factory that was producing counterfeit homeopathic drugs. The counterfeiters were attaching the labels of other drug producers to the remedies they were producing in their own factory. Dhaka's Daily Star reported the bust with the rather ironic headline "Fake Medicine Factory Busted".

Of course, even homeopathic remedies need to be guaranteed safe if they are sold in stores, and counterfeiters are not bound by the same safety controls as other more reputable sources. There are also 'intellectual property' issues concerning the use of other company's labels and trademarks. So I am not here to tell you that this drug bust was unnecessary or ridiculous. In fact I want to challenge The Star's implicit suggestion that homeopathic remedies are by their nature counterfeit therapies.

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Paying people to lose weight

Winton Rossiter, of London weight-loss firm 'Weight Wins', was in the news this week, following the completion of a trial in which obese patients were paid to lose weight.

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Synthetic biology: eroding the moral distinctions between animate and inanimate.

Sometimes science reveals distinctions to be false. Time and space were thought to be distinct, separate things, until Einstein showed that they were fundamentally intertwined. Graphite and diamond were thought to be made of distinct substances, until Tennant showed that they would release the same gas when burned.

In a similar way, progress in the field of synthetic biology is eroding the longstanding moral and theoretical distinctions we make between life and machinery. The recent breakthrough by Venter's group proves that life may be built from its component parts, and set into motion, just like inanimate machinery. No divine spark is required, no soul need be blown into the cells. Life no longer even requires a parent or progenitor.

One of the most widespread and longstanding moral beliefs is that there is an important difference between living organisms and inanimate machines. Nearly everybody agrees that there are moral boundaries on our treatment of living things. For vegetarians or vegans, this may include a belief that we should never intentionally kill another living being. For others, it may include a belief that we ought never to interfere with the cellular mechanics of a living being, as we do when we produce genetically-modified foods.

By contrast, nobody thinks that it is wrong to destroy, create, or tamper with a machine — even if the machine in question is exceedingly complex. This moral distinction is put in crisis by the synthetic biology projects of Venter and others. Going forward, we will need to find a more meaningful moral distinction than the line between the animate and the inanimate. Failing that, we are faced with an unacceptable set of alternatives: either to grant machines the moral status we currently accord to living things, or to treat living things in the manner of machines.

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