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NeuroLaw: Do we have a responsibility to use neuroscience to inform law?

The airwaves buzzed last week on BBC radio about biological predispositions towards violence, brain-based lie detection systems, tumors associated with pedophilia, and psychopaths.  The BBC looked to the Neuroethics Centre’s own Walter Sinott-Armstrong for his perspective on neuroscience in law in light of the release of the Royal Society’s recent report on the topic (on which he acted as a reviewer). The short and sweet BBC podcast can be found here (the segment on NeuroLaw begins at 12:52). While much of the debate so far has focused on the dangers neuroscience might bring to the legal system and therefore on caution in the adoption of neuroscience in legal settings, Walter Sinott-Armstrong pointed out that the potential to help is also huge. Neuroscience investigating the brain networks active in chronic pain could help build evidence that someone is suffering chronic pain. It might compliment actuarial risk estimates to help better estimate future dangerousness when offenders are up for parole (an area where expert opinion by psychologists is notorious wrong 2 out of 3 times). And it may help identify cases of shaken-baby syndrome.  And with this potential, it raises the intriguing question: do we have a responsibility to use neuroscience in law?

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Conjoined Twins: Who Should Live and Who Should Die?

A 23 – year old has given birth to conjoined twins in Brazil. The two boys have separate brains and spinal columns, but share other major organs, including heart, lungs and liver.
 
The twins, who have dicephalic parapagus, an extremely rare disorder, are in a stable condition, and there are no current plans to surgically separate them. Doctor Neila Dahas of Santa Casa de Misericordia Hospital, where they are currently under care and observation, said, “it is impossible to take a decision with relation to surgery, not only because of physical reasons, but ethical ones as well.”

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A Slave to Christmas Pudding?

For many of us, there is probably no better time of year to think about weakness of will. Some will be mentally preparing themselves to resist the temptations of the Christmas table, while others, already knowing that in their case such preparations are pointless, will be assuring themselves that a new year’s resolution to revisit… Read More »A Slave to Christmas Pudding?

Water, food or energy: we won’t lack them

The world is full of problems. Pollution is a problem. The destruction of the coral reefs, the eradication of the rain forests, the mass extinction of animal species are problems, and tragedies. Loss of biodiversity is a problem. Global warming is a problem. Poverty and the unequal distribution of resources are major problems.

But lack of basic resources isn’t a problem. We’ll have enough food, water and energy for the whole human race for the forseable future, at reasonable costs. Take a worse-case scenario for all three areas, and let’s look at the figures.

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What Moral Virtues Should We Enhance?

Yesterday evening in front of a record audience in the OxfordMartinSchoolbuilding, Dr. Molly Crockett delivered the Wellcome Lecture in Neuroethics: “Moral enhancement? Evidence and challenges” (a podcast of the lecture will soon appear in the events archives here)

In her engaging talk, Dr Crockett spoke of the emerging body of neuroscience research she and others have been conducting on neurobiological modifiers of moral behavior and how manipulations in neurotransmitter systems can affect that moral behavior.

For example, in a study where subjects were presented with two classic trolley problems, whether they had previously received an antidepressant that increased the availability of the neurotransmitter, serotonin, in the neuronal synapse (in this case, a Selective Serotonin Reuptake Inhibitor – SSRI) significantly shifted peoples decisions into a deontological, as opposed to consequentialist framework. Namely, the group that had received the SSRI was less likely to say it was ok to push a very large man off of a bridge in front of a trolley in order to save five workers who would certainly otherwise die.

From a deontological point of view, this increased aversion to harming others after taking the SSRI might be thought of as a moral enhancement, but might be thought of as impairment to a consequentialist.

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The cost of living and the cost of dying

X, a patient with reliably diagnosed PVS, lies in a hospital bed for years, fed via a nasogastric tube. He has not, and by definition never will have, any capacity for pain, pleasure or any sort of sensation. Devoted family members come each day to sit by his bedside, but he has no idea that they are devoted, or that they exist.
It is expensive to keep him alive. He occupies a bed and consumes a good deal of nursing time.
The NHS Trust responsible for his care has a limited budget. It decides that the money spent on maintaining his merely biological life would be better spent on dialysis machines. It can, and does, justify its decision in purely utilitarian terms. It writes in the minutes of the relevant committee meeting: ‘For the money we spend keeping X alive, we can save the lives of 10 kidney patients, each of whom will have a good quality of life for many years. The QALY arithmetic makes X’s continued existence nonsensical.’Read More »The cost of living and the cost of dying

What is feasible?

Climate change raises questions of global distributive justice and I am interested in what kinds of actions might be considered as fair responses.  Recently, I have observed that some accounts of climate justice have been dismissed for being “infeasible”.  I have started to wonder what this means.   In ordinary language, “feasible” might mean “possible” or “likely”, even “easy” or “inexpensive”  – with infeasible meaning the opposite.   What kind of criticism is it to say that an account of climate justice, for example, the distribution of equal per capita shares of greenhouse gas emissions is “infeasible”?  It might be presented as an empirical claim: that such a proposal will not be acted upon, or, at least, is unlikely to be acted upon.  This does not mean that the account is lacking on normative grounds.  People are not always that good at being good.     Read More »What is feasible?

Discovering Consciousness in the “Permanently Unconscious”: What Should We Do?

Comment on “Bedside detection of awareness in the vegetative state: a cohort study” by Damian Cruse, Srivas Chennu, Camille Chatelle, Tristan A Bekinschtein, Davinia Fernández-Espejo, John D Pickard, Steven Laureys, Adrian M Owen. Published in The Lancet, online Nov 10.

 Cruse and colleagues founds evidence of some kind of consciousness in 3 out of 16 patients diagnosed as being permanently unconscious. They used an EEG machine, capable of being deployed at the bedside. Is this good news?

This important scientific study raises more ethical questions than it answers. People who are deeply unconscious don’t suffer. But are these patients suffering? How bad is their life? Do they want to continue in that state? If they could express a desire, should it be respected?

The imporMan in Prisontant ethical question is not: are they conscious? It is: in what way are they conscious? Ethically, we need answers to that. Life prolonging treatment has been and legally can be withdrawn from patients who are permanently unconsciousness. We need guidelines for when life-prolonging treatment should be withdrawn in these minimally conscious states. Paradoxically, it could be worse for some than being permanently unconscious. And in countries like the Netherlands, we need guidelines on whether and when active euthanasia should be performed. For some of these patients, consciousness could be the experience of a living hell.

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