Science and Ethics: Deep brain stimulation for the treatment of anorexia

Hannah Maslen and Julian Savulescu

In a pioneering new procedure, deep brain stimulation is being trialed as a treatment for the eating disorder anorexia nervosa. Neurosurgeons at the John Radcliffe Hospital in Oxford implanted electrodes into the nucleus accumbens of a woman suffering with anorexia to stimulate the part of the brain involved in finding food rewarding. Whilst reports emphasize that this treatment is ‘highly experimental’ and would ‘only be for those who have failed all other treatments for anorexia’, there appeared to be tentative optimism surrounding the potential efficacy of the procedure: the woman who had undergone the surgery was reportedly ‘doing well’ and had shown ‘a response to the treatment’.

It goes without saying that successful treatments for otherwise intractable conditions are a good thing and are to be welcomed. Indeed, a woman who had undergone similar treatment at a hospital in Canada is quoted as saying ‘it has turned my life around. I am now at a healthy weight.’ However, the invasive nature of the procedure and the complexity of the psychological, biological and social dimensions of anorexia should prompt us to carefully consider the ethical issues involved in offering, encouraging and performing such interventions. We here outline relevant considerations pertaining to obtaining valid consent from patients, and underscore the cautious approach that should be taken when directly modifying food-related desires in a complex disorder involving interrelated social, psychological and biological factors. Continue reading

Mind wars: do we want the enhanced military?

Jonathan Moreno presented a special lecture the 18th about “Mind Wars”, the military applications of neurotechnology. Here are some of my notes and comments inspired by this stimulating lecture. Continue reading

Smart pills vs. motivation pills – is one morally worse than the other?

Imagine a huge pile of unwashed dishes reminds you that you should clean your kitchen. Would you rather take a pill that increases your ability to clean very elaborately or one that helps you get off the couch and actually bring yourself to start cleaning? No hard decision for me…

Certain substances like methylphenidate can not only enhance cognition, but also motivation or, to be more precise, self-regulation. This is not too surprising as treating conditions associated with decreased self-regulation like ADHD often is a main purpose of such medication. Continue reading

Self-consciousness and moral status

Many share an intuition that self-consciousness is highly morally significant. Some hold that self-consciousness significantly enhances an entity’s moral status. Others hold self-consciousness underwrites the attribution of so-called personhood (or full moral status) to self-conscious entities. On such views, self-consciousness is highly morally significant: the fact that an entity is self-conscious generates strong moral reasons to treat that entity in certain ways (reasons that, for example, make killing such entities a very serious matter).

Why believe that? Continue reading

Neil Levy’s 2nd Leverhulme Lecture: “The Science of Self-Control”

Yesterday Neil Levy delivered the second of three Leverhulme lectures. The topic this time: “The Science of Self-Control.” In these lectures, Levy is setting two views against each other. The first is a view that emphasizes willpower – when tempted, one must grit it out. The second is a view that emphasizes self-management – the way to avoid temptation is to objectify ourselves, understand what triggers failures of self-control, and put ourselves in environments without temptation. Like Ulysses aware of the nearness of Sirens, we ought to find ways to tie ourselves to the mast.

What does science have to do with this? Levy argues that science is indicating the preferability of a self-management view. Continue reading

Where there’s a will there’s a way: Enhancing motivation

by Hannah Maslen, Julian Savulescu and Carin Hunt

A study examining pharmaceutical cognitive enhancement found that participants’ subjective enjoyment of various memory and problem-solving tasks was significantly greater when they had taken modafinil (a drug originally developed for narcolepsy) compared with placebo, but that mood ratings overall were not affected (Muller at al 2013). The authors of the paper therefore concluded that, in addition to the various performance effects, ‘an important finding of this study is that there was a striking increase in task motivation’. Whilst a lot of attention has been paid to the ethical implications of enhancing cognitive performance, much less has been paid to the striking task-motivation finding. We suggest, however, that motivation enhancement might be the more contentious effect, from an ethical point of view. Continue reading

What are the ethics of using brain stimulation technologies for ‘enhancement’ in children?

New open access publication: announcement:

In a recently published article, Hannah Maslen, Roi Cohen Kadosh, Julian Savulescu and I present an argument about the permissible (and not-so-permissible) uses of non-invasive brain stimulation technology in children. We consider both children who may be suffering from a specific neurological disorder, for whom the stimulation is intended as a ‘treatment’, and those who are otherwise healthy, for whom the stimulation is intended as ‘enhancement’. For the full article and citation, see here:

Maslen, H., Earp, B. D., Cohen Kadosh, R., & Savulescu, J. (2014). Brain stimulation for treatment and enhancement in children: An ethical analysisFrontiers in Human Neuroscience, Vol. 8, Article 953, 1-5. Continue reading

Biomedical enhancement and the need for more precise conceptions

Much of the discussion about biomedical enhancements is about arguing whether some biomedical enhancement would, or would not be a good, ethical, or efficient means for enhancing a particular human characteristic. In this blog and in other bioethical literature bioethicists discuss the proposed effects that biomedical enhancements would have, for example, to intelligence and other cognitive capacities, empathy, sunny mood, altruism, sense of justice, or to halting climate change. The list is extensive and endless. The discussion on efficacy, ethics, justice, and human nature is an important part of the whole philosophical debate, as is the discussion about the limits of philosophy, reality, and science fiction. However, an important point that might be in need of emphasis would be to take under inspection the very concepts that are the target of enhancement. What do intelligence, sunny mood, altruism, sense of justice, and the-characteristics-that-prevents-us-halting-climate-change really mean?

If the target characteristics are looked at carefully, it seems that much of the discussion can be described as a form of language bewitchment where conceptions of the human language and conceptions of the empirical science of biology are mixed. Just because the human language includes conceptions such as intelligence, altruism, sunny mood, criminal, and sense of justice, it does not mean that there would be any corresponding concrete physical entities to these conceptions.

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Sinnott-Armstrong on Implicit Moral Attitudes

On October 30th, Professor Walter Sinnott-Armstrong of Duke University gave the 2014 Wellcome Lecture in Neuroethics.  His talk, “Implicit Moral Attitudes”, concerned the practical and theoretical implications of recent empirical research into unconscious or sub-conscious beliefs or associations.  Recordings of his talk will be made available soon Audio recording of the talk is available here: http://media.philosophy.ox.ac.uk/neuro/MT14_WLN_WSA.mp3For those interested that were unable to attend, I will summarise the main points of Sinnott-Armstrong’s talk and some of the discussion that occurred during the Q&A afterwards. Continue reading

Moral Enhancement Won’t Work For The Very Reason It Is Claimed To Be Desirable

Guest Post: Alexander Andersson, MA student in practical philosophy, University of Gothenburg
Email: gusandall[at]student.gu.se

In Unfit for the Future: The Need for Moral Enhancement, Ingmar Persson and Julian Savulescu argue that we, as a human race, are in deep trouble. According to the authors, global-warming, weapons of mass destruction, poverty, famine, terrorists, and even liberal democracies candidate as components in our potential apocalypse. These issues that we are facing require us to be able to make the morally right decisions, however, our current moral deficiencies seem to prevent us from making those decisions. As the authors put it:

[H]uman beings are not by nature equipped with a moral psychology that empowers them to cope with the moral problems that these new conditions of life create. Nor could the currently favoured political system of liberal democracy overcome these deficiencies. (Persson & Savulescu, 2012, p. 1)*

It is therefore desirable to look for means or solutions to get rid of these deficiencies, which in turn would make us morally better persons, thus allowing us to avoid the disastrous situations which otherwise lies ahead. Luckily, Persson and Savulescu do not seem to suffer from moral deficiency, which enables them to put forth a creative plan to save the day.

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