Video Series: Dominic Wilkinson on Conscientious Objection in Healthcare

Associate Professor and Consultant Neonatologist Dominic Wilkinson (Oxford Uehiro Centre for Practical Ethics) argues that medical doctors should not always listen to their own conscience and that often they should do what the patient requests, even when this conflicts with their own values.

The Way Forward: Mapping Brains and Finding Direction

According to a recent report in the New York Times, the United States government will soon announce plans to fund the Brain Activity Map. Modelled on the highly successful Human Genome Project, the Brain Activity Map is an effort to identify functional networks of neurons, possibly leading to a full understanding of how mental processes like perception and memory are physically distributed in the brain. The scientific and medical potentials, perhaps including new treatment of conditions like schizophrenia or autism, are fantastic. By developing monitoring techniques like calcium imaging, nanoparticle sensor detection, or synthetic-DNA chemical recording, neuroscientists hope to be able to trace the paths traveled by our thoughts and memories. Yet before setting off on this cartographic adventure, perhaps we ought first stop, and remind ourselves where we already are.

In a 2012 Neuron paper proposing the Brain Activity Map, a group of leading scientists briefly acknowledge some ethical worries, including “issues of mind-control, discrimination, health disparities, unintended short- and long-term toxicities…” This is a reasonable, if somewhat eclectic, list of concerns. But I would like to add one more. Brain-mapping, like gene-mapping, risks making us overconfident in our self-understanding. The better we come to understand our brains, the more tempting it will be to assume we understand our selves.

Think for a moment about the history of major advances in human-directed science: Darwinism, psychoanalytics, behaviourism, sociobiology, cybernetics, genomics. With each progression has come a deluge of sweeping assertions about the new completeness of our self-understanding, followed later by a far quieter admission that whatever else we may be, we are also mysteries. In the worst moments, our fleeting certitude fuelled attempts to reorganize societies along purportedly scientific lines, from racist eugenics to disastrous Marxist utopianism. Even when spared catastrophic miscalculation, we’ve still suffered coarsening reductions in public debate about human nature, where hopes and commitments were temporarily replaced by operant reinforcements or behavioural phenotypes.

The point here is not to deny the reality of scientific descriptions of humanity, nor to retreat into a neo-Romantic induced ignorance. The point is simply to sound a warning, to jot a note to ourselves in this relatively sober moment, before the allure of the scientifically novel begins to blindingly illuminate our horizons. Maps are awesomely seductive bearers of information, so simply compact and so seemingly complete. Mapped brains will be more potent still, enfolding the vanity of portraiture in the certainty of topography.

I’m aware that what I am articulating is not so much an argument as an anxiety. I have no simple take-home message to offer, no action plan or policy recommendation. Certainly we should not attempt to stop the sort of research offered by the Brain Activity Map. Rather, we should support it, fund it, train our children to carry it forward. The potential benefits, to theoretical knowledge and human well-being, are incredible. But there are costs, or at least risks. It would be best to reach first for a bit of preventive humility, a dash of recognition that there are limits on the self-understanding of even such an expert auto-empiricizer as homo sapiens. In Franz Joseph Gall’s original phrenological map, the brain area for Circumspection and Forethought was located right next to the brain area for Vanity.


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