In addition to money for research, the federal Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative included a request to review the ethical issues around neuroscience research and the ethical implications of what researchers may discover. Last week, the Presidential Commission for the Study of Bioethical Issues released its first report, Gray Matters: Integrative Approaches for Neuroscience, Ethics, and Society. It focuses on research; a second report will focus on implications.
The commission recommends that questions and discussion of ethics should be integrated at every stage of science research: learning science in schools, planning and performing studies, through to publishing and discussing results. Here’s the 4-point summary (from pp. 43–5 of the report):
Recommendation 1: Integrate Ethics Early and Explicitly Throughout Research
Institutions and individuals engaged in neuroscience research should integrate ethics across the life of a research endeavor, identifying the key ethical questions associated with their research and taking immediate steps to make explicit their systems for addressing those questions. Sufficient resources should be dedicated to support ethics integration.
Once implemented, systems for integrating ethics and neuroscience research should not operate in a vacuum. Institutions and individuals engaged in neuroscience research should learn from collective experience to improve existing systems and inform others about what works and what does not.
Recommendation 2: Evaluate Existing and Innovative Approaches to Ethics Integration
Government agencies and other research funders should initiate and support research that evaluates existing as well as innovative approaches to ethics integration. Institutions and individuals engaged in neuroscience research should take into account the best available evidence for what works when implementing, modifying, or improving systems for ethics integration.
One foundational approach to integration is pairing science and ethics education at all levels of education. Early ethics education in academic settings is critical to prepare future scientists to integrate ethical considerations into their work—including future research in neuroscience. Professional development for experienced investigators is equally important and can serve multiple ends, contributing not only to their individual knowledge, but to the knowledge of the students and young scientists that they mentor as well.
Recommendation 3: Integrate Ethics and Science through Education at All Levels
Government agencies and other research funders should initiate and support research that develops innovative models and evaluates existing and new models for integrating ethics and science through education at all levels.
It has been just over a year since the announcement of the BRAIN Initiative, and institutions participating in this research effort have an important opportunity to integrate ethics and science from the outset. A key component of this integration is the inclusion of ethicists or scientists with experience in ethics in BRAIN Initiative-related scientific advisory boards and funding review committees, particularly for the major public and private sector partners.
Recommendation 4: Explicitly Include Ethical Perspectives on Advisory and Review Bodies
BRAIN Initiative-related scientific advisory and funding review bodies should include substantive participation by persons with relevant expertise in the ethical and societal implications of the neuroscience research under consideration.
The report reads like a report—a little dry—but it is readable and clear and short. It repeatedly makes the point that talking about ethics does not stifle research, but enriches it. It also does not decrease interest in science among high-school students, but increases it, according to an NIH report. Also the commission makes clear that waiting to talk about ethics of research until people are in college is too late—and waiting until scientists are in the midst of research in post-grad studies is way, way too late.
Perhaps because it will treat the topic more in the second report, this one seems to skim over the argument that is strongest to me: Everyone—not just people who do science—needs to think about the ethics of neuroscience because everyone’s brain (and so life) will be influenced by it. Just a few influencers include drugs like Ritalin and alcohol, treatments for concussions or stroke, technologies that could potentially read your mind, “cognitive enhancers” that your workplace might require you to take, and the range of choices you can make in your own healthcare. Here’s one example (p. 7 of the report):
Consider, for example, a man who, prior to having dementia, expressed a strong and clear preference against invasive treatments if his cancer were to return. The cancer recurs many years later after his dementia has progressed, at which time he insists on major surgery that might extend his life, but is unlikely to markedly improve its quality. The ethical question of whether to move forward with the surgery focuses on whether his pre-dementia or post-dementia preferences should take priority and which decision best reflects his overall wishes and best interests.
All this integration will require money and support, from funding agencies and foundations, from school administrations, and especially from the public, who pays for government funding and schools. The bioethics commission has been very open about its proceedings, with public meetings and social media outreach. It plans at least two more public meetings before issuing the next report; find out more at http://www.bioethics.gov/ and @bioethicsgov.