Written by Stephen Rainey

Brain-machine interfaces (BMIs), or brain-computer interfaces (BCIs), are technologies controlled directly by the brain. They are increasingly well known in terms of therapeutic contexts. We have probably all seen the remarkable advances in prosthetic limbs that can be controlled directly by the brain. Brain-controlled legs, arms, and hands allow natural-like mobility to be restored where limbs had been lost. Neuroprosthetic devices connected directly to the brain allow communication to be restored in cases where linguistic ability is impaired or missing.

It is often said that such devices are controlled ‘by thoughts’. This isn’t strictly true, as it is the brain that the devices read, not the mind. In a sense, unnatural patterns of neural activity must be realised to trigger and control devices. Producing the patterns is a learned behaviour – the brain is put to use by the device owner in order to operate it. This distinction between thought-reading and brain-reading might have important consequences for some conceivable scenarios. To think these through, we’ll indulge in a little bit of ‘science fiction prototyping’.

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Guest Post: Mind the accountability gap: On the ethics of shared autonomy between humans and intelligent medical devices

Guest Post by Philipp Kellmeyer

Imagine you had epilepsy and, despite taking a daily cocktail of several anti-epileptic drugs, still suffered several seizures per week, some minor, some resulting in bruises and other injuries. The source of your epileptic seizures lies in a brain region that is important for language. Therefore, your neurologist told you, epilepsy surgery – removing brain tissue that has been identified as the source of seizures in continuous monitoring with intracranial electroencephalography (iEEG) – is not viable in your case because it would lead to permanent damage to your language ability.

There is however, says your neurologist, an innovative clinical trial under way that might reduce the frequency and severity of your seizures. In this trial, a new device is implanted in your head that contains an electrode array for recording your brain activity directly from the brain surface and for applying small electric shocks to interrupt an impending seizure.

The electrode array connects wirelessly to a small computer that analyses the information from the electrodes to assess your seizure risk at any given moment in order to decide when to administer an electric shock. The neurologist informs you that trials with similar devices have achieved a reduction in the frequency of severe seizures in 50% of patients so that there would be a good chance that you benefit from taking part in the trial.

Now, imagine you decided to participate in the trial and it turns out that the device comes with two options: In one setting, you get no feedback on your current seizure risk by the device and the decision when to administer an electric shock to prevent an impending seizure is taken solely by the device.

This keeps you completely out of the loop in terms of being able to modify your behaviour according to your seizure risk and – in a sense – relegates some autonomy of decision-making to the intelligent medical device inside your head.

In the other setting, the system comes with a “traffic light” that signals your current risk level for a seizure, with green indicating a low, yellow a medium, and red a high probability of a seizure. In case of an evolving seizure, the device may additionally warn you with an alarm tone. In this scenario, you are kept in the loop and you retain your capacity to modify your behavior accordingly, for example to step from a ladder or stop riding a bike when you are “in the red.”

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A Second Response to Professor Neil Levy’s Leverhulme Lectures.

Written by Richard Ngo , an undergraduate student in Computer Science and Philosophy at the University of Oxford.

Neil Levy’s Leverhulme Lectures start from the admirable position of integrating psychological results and philosophical arguments, with the goal of answering two questions:

(1) are we (those of us with egalitarian explicit beliefs but conflicting implicit attitudes) racist?

(2) when those implicit attitudes cause actions which seem appropriately to be characterised as racist (sexist, homophobic…), are we morally responsible for these actions? Continue reading

Loebel Lecture 3 of 3: What is the upshot?

Lecture 3 Audio [MP3] | YouTube link [MP4] 
Grove Auditorium, Magdalen College, Longwall Street, Oxford
5 November 2015, 6-8pm Continue reading

Loebel Lectures and Workshop, Michaelmas Term 2015, Lecture 1 of 3: Neurobiological materialism collides with the experience of being human

The 2015 Loebel Lectures in Psychiatry and Philosophy were delivered by Professor Steven E. Hyman, director of the Stanley Center for Psychiatric Research at the Broad Institute of MIT and Harvard as well as Harvard University Distinguished Service Professor of Stem Cell and Regenerative Biology. Both the lecture series and the one-day workshop proved popular and were well-attended. Continue reading

Guest Post: Should the army abandon their zero-tolerance policy on substance use?

Written by Anke Snoek

Macquarie University

In the UK around 500 soldiers each year get fired because they fail drug-testing. The substances they use are mainly recreational drugs like cannabis, XTC, and cocaine. Some call this a waste of resources, since new soldiers have to be recruited and trained, and call for a revision of the zero tolerance policy on substance use in the army.

This policy stems from the Vietnam war. During the First and Second World War, it was almost considered cruel to deny soldiers alcohol. The use of alcohol was seen as a necessary coping mechanism for soldiers facing the horrors of the battlefield. The public opinion on substance use by soldiers changed radically during the Vietnam War. Influenced by the anti-war movement, the newspapers then were dominated by stories of how stoned soldiers fired at their own people, and how the Vietnamese sold opioids to the soldiers to make them less capable of doing their jobs. Although Robins (1974) provided evidence that the soldiers used the opioids in a relatively safe way, and that they were enhancing rather than impairing the soldiers’ capacities, the public opinion on unregulated drug use in the army was irrevocably changed. Continue reading

“The medicalization of love” – podcast interview

Just out today is a podcast interview for Smart Drug Smarts between host Jesse Lawler and interviewee Brian D. Earp on “The Medicalization of Love” (title taken from a recent paper with Anders Sandberg and Julian Savulescu, available from the Cambridge Quarterly of Healthcare Ethics, here).

Below is the abstract and link to the interview:


What is love? A loaded question with the potential to lead us down multiple rabbit holes (and, if you grew up in the 90s, evoke memories of the Haddaway song). In episode #95, Jesse welcomes Brian D. Earp on board for a thought-provoking conversation about the possibilities and ethics of making biochemical tweaks to this most celebrated of human emotions. With a topic like “manipulating love,” the discussion moves between the realms of neuroscience, psychology and transhumanist philosophy. 


Earp, B. D., Sandberg, A., & Savulescu, J. (2015). The medicalization of love. Cambridge Quarterly of Healthcare Ethics, Vol. 24, No. 3, 323–336.

Guest Post: Mental Health Disorders in Prison: Neuroethical and Societal Issues

 Guest post by Barbara Sahakian,

FMedSci, DSc, a professor in the department of psychiatry at the University of Cambridge,

and president of the International Neuroethics Society.

This article was originally published on the Dana Foundation Blog, and can be read here:

More than half of all prison and jail inmates have a mental health problem.[i] In addition, according to a 2010 report released by the Treatment Advocacy Center and the National Sheriffs’ Association,[ii] more mentally ill persons are in jails and prisons than in hospitals, and many of those remain untreated. Those in prison have a higher risk of substance abuse, and suicide rates are four to five times higher than within the general population.[iii] Deaths are also increased upon release, with the most common reasons being drug overdose, cardiovascular disease, homicide, and suicide.[iv]

Many people in prison have lower than average IQs, and it is well-established that lower IQ is a known risk factor for mental health problems.[v] Rates of problems for children in the youth justice system are at least three times higher than within the general population, and are highest amongst children in custody.[vi] Almost a quarter of children who offend have very low IQs of less than 70.[vii]

At the International Neuroethics Society Annual Meeting 2015 in Chicago (Oct. 15-16), there will be a panel entitled, “Mental health disorders in prison: Neuroethical and societal issues,” which will consider vulnerabilities to mental health problems of those in prison, and whether there are inequalities in access to psychiatrists, psychologists, and other professionals for diagnosis and treatment. This panel will also reflect on what steps, in terms of improving cognition, functionality, and wellbeing, society should be taking to ensure better life trajectories when inmates with mental health problems are released.

For example, suicide mortality is reduced by antidepressant treatment,[viii] and there is evidence that for at least some disorders, such as attention deficit hyperactivity disorder (ADHD), treatment leads to a significant reduction in criminality rates in men (Lichtenstein et al, 2012).[ix] Effective treatment of neuropsychiatric disorders and education, including skill training in prisons, could help to increase cognitive reserve and resilience, helping prisoners successfully address the many challenges encountered on release.[x]

The highly distinguished panel includes Dr. James Blair, Dr. Laurie R. Garduque, and Professor Hank Greely. The panel’s moderator, Dr. Alan Leshner, has been director of the National Institute on Drug Abuse, deputy director and acting director of the National Institute of Mental Health, and chief executive officer of the American Association for the Advancement of Science. He was one of the first to highlight the neuroscientific evidence of brain changes in addiction.

[i] James DJ, Glaze LE (2006) Mental health problems of prison and jail inmates. Bureau of Justice Statistics, NCJ 213600

[ii] Torrey E, Kennard A, Eslinger D, Lamb R, Pavle J (2010) More Mentally Ill Persons are in Jails and Prisons than Hospitals: A Survey of the States. Treatment Advocacy Center.

[iii] Fazel S, Grann M, Kling B, Hawton K (2011) Prison suicide in 12 countries: An ecological study of 861 suicides during 2003–2007. Soc Psychiatry Psychiatr Epidemiol, 46, 191-195.

[iv] Binswanger IA, Stern MF, Deyo RA, Heagerty PJ, Cheadle A, Elmore JG, Koepsell TD (2007) Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356, 157-165.

[v] Barnett JH, Salmond CH, Jones PB, Sahakian BJ (2006) Cognitive reserve in neuropsychiatry. Psychological Medicine, 36, 1053-1064.

[vi] Hagell A (2002) The mental health needs of young offenders—a report commissioned by the Mental Health Foundation MHF: London.

[vii] Harrington R, Bailey S (2005) Mental health needs and effectiveness of provision for young offenders in custody and in the community YJB: London.

[viii] Morgan OWC, Griffiths C, Majeed A (2004) Association between mortality from suicide in England and antidepressant prescribing: an ecological study. BMC Public Health, 4.

[ix] Lictenstein P, Halldner L, Zetterqvist J, Sjolander A, Serlachius E, Fazel S, Langstrom N, Larsson H (2012) Medication for attention deficit-hyperactivity disorder and criminality. The New England Journal of Medicine, 367.

[x] Beddington J, Cooper CL, Field J, Goswami U, Huppert FA, Jenkins R, Jones HS, Kirkwood TB, Sahakian BJ, Thomas SM (2008) The mental wealth of nations. Nature, 23, 1057-1060.

Guest Post: Must we throw out the brain with the bathwater? Marc Lewis on addiction

Written by Anke Snoek

Macquarie University

When neuroscience started to mingle into the debate on addiction and self-control, people aimed to use these insights to cause a paradigm shift in how we judge people struggling with addictions. People with addictions are not morally despicable or weak-willed, they end up addicted because drugs influence the brain in a certain way. Anyone with a brain can become addicted, regardless their morals. The hope was that this realisation would reduce the stigma that surrounds addiction. Unfortunately, the hoped for paradigm shift didn’t really happen, because most people interpreted this message as: people with addictions have deviant brains, and this view provides a reason to stigmatise them in a different way. Continue reading

Guest Post: Smart drugs, Smart choice

Written by Benjamin Pojer and Daniel D’Hotman

Faculty of Medicine, Nursing and Health Science, Monash University

 Oxford Uehiro Centre for Practical Ethics, University of Oxford


A recent review published in the European Journal of Neuropsychopharmacology (1) on the efficacy and safety of modafinil in a population of healthy people has found that the drug “appears to consistently engender enhancement of attention, executive functions, and learning” without “preponderances for side effects or mood changes”. Modafinil, a medication prescribed in the treatment of narcolepsy and other sleep disorders, has gained popularity in recent years as a means of increasing alertness and focus. Informal surveys suggest that up to one in five undergraduate university students in the UK admit to using the drug as a study aid (2). Previously, the unknown safety profile of modafinil has been an obstacle to its more widespread use as a cognitive enhancer. Admittedly, the long-term consequences of modafinil use remain unclear, however, given its growing popularity, this gap in the literature should not preclude a discussion of the ethics of the drug’s use for cognitive enhancement. Continue reading


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