Abstract
This chapter examines the emerging ethical challenges raised by implementation of nanotechnology in brain devices for enhancement purposes in subjects with healthy brains. This chapter will proceed in five steps. The first section introduces brain implants and discusses how their status may be changed by nanotechnologies for enhancement purposes. The second section explores whether the ethics of nano-bionic devices for cognitive enhancement purposes in healthy, informed subjects might be helped by referring to the treatment-enhancement distinction. Such a distinction could serve to illuminate guidelines and policies. The third section examines whether the designs for nano-bionic devices for cognitive enhancement raise a number of intrinsically new ethical problems if applied to healthy subjects. The fourth section looks at whether nano-bionic devices used for the purpose of enhancement introduce novel ethical difficulties to the informed consent of healthy and free subjects. The fifth section sketches the preliminary ethics that have to be established before a healthy individual could undergo an informed consent process for invasive nano-bionics brain intervention.
Keywords
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- 1.
I assume that enhancers have an enhancement effect in any body (i.e. a healthy body and a sick body). For instance, growth hormones affect any body, not only a body with disease. However, not all treatment will have an enhancement effect (i.e. a healthy body and a sick body). For example, could a treatment with radiation or a treatment for influenza enhance a healthy body?
- 2.
“L’espèce humaine doit-elle s’améliorer, soit par de nouvelles découvertes dans les sciences […]; soit enfin par le perfectionnement réel des facultés intellectuelles, morales et physiques, qui peut être également la suite, ou de celui des instruments qui augmentent l’intensité et dirigent l’emploi de ces facultés” (Condorcet 2004: 430).
- 3.
The debate on somatic nuclear transfer for reproductive purpose (reproductive cloning) has been monopolized and depicted without accuracy by the media. This phenomenon has dragged ethical questions on speculative ground and shifted the focus away from issues of safety and efficacy.
References
Adrian W, Laxton Tang-Wai DF, McAndrews MP et al (2010) A phase I trial of deep brain stimulation of memory circuits in Alzheimer’s disease. Ann Neurol 68(4):521–534
Alpert S (2008) Neuroethics and nanoethics: do we risk ethical myopia? Neuroethics 1:55–68
Andrews RJ (2009) Neuromodulation: deep brain stimulation, sensory neuroprostheses, and the neural-electrical interface (In: Sharma HS (ed) Nanoneuroscience and nanoneuropharmacology). Prog Brain Res 180:127–139
Bell E, Maxwell B, McAndrews MP, Sadikot A, Racine E (2010) Hope and patients’ expectations in deep brain stimulation: healthcare providers’ perspectives and approaches. J Clin Ethics 21:112–124
Berger F, Gevers G, Siep L, Weltring KM (2008) Ethical, legal and social aspects of brain-implants using nano-scale materials and techniques. Nanoethics 2:241–249
Berney A, Vingerhoets F, Perrin A, Guex P, Villemure J-G, Burkhard PR, Benkelfat C, Ghika J (2002) Effect on mood of subthalamic DBS for Parkinson’s disease: a consecutive series of 24 patients. Neurology 59:1427–1429
Bostrom N (1998) What is transhumanism? http://www.nickbostrom.com/old/transhumanism.html. Accessed 18 Apr 2012
Bostrom N, Savulescu J (2009) Human enhancement ethics: the state of the debate. In: Savulescu J, Bostrom N (eds) Human enhancement. Oxford University Press, Oxford
Clausen J (2010) Ethical brain stimulation – neuroethics of deep brain stimulation in research and clinical practice. Eur J Neurosci 32:1152–1162
Condorcet N (2004) Tableau historique des \( {\rm progr\grave{e}s} \) de l’esprit humain. Projets, esquisee, fragments et notes (1772–1974). Schandeler J.-P, et Crépel P (eds) Paries: Institut National d’Etudes Démographique
Curiel DT, Agarwal S, Wagner E, Cotton M (1991) Adenovirus enhancement of transferrin-polylysine-mediated gene delivery. Proc Natl Acad Sci USA 88:8850–8854
Daniels N (2000) Normal functioning and the treatment-enhancement distinction. Camb Q Healthc Ethics 9:309–322
Davis J (2009) Peoria’s first cochlear implant surgery has grandfather rediscovering life. Peoria Journal Star, 2009-10-29. http://www.pjstar.com/features/x876590686/Peoria-s-first-cochlear-implant-surgery-has-grandfather-rediscovering-life. Accessed 7 Mar 2011
de Condorcet N (1795) Outlines of an historical view of the progress of the human mind [1793]. J. Johnson, London
Drexler EK (1986) Engines of creation: the coming era of nanotechnology. Anchor Books, New York, http://e-drexler.com/d/06/00/EOC/EOC_Table_of_Contents.html
Elliott C (2003) Better than well: American medicine meets the American dream. Norton, New York
Ferrari A, Nordmann A (2010) Beyond conversation: some lessons for nanoethics. Nanoethics 4:171–181
Ford PJ (2009) Vulnerable brains: research ethics and neurosurgical patients. J Law Med Ethics 37:73–83
Franzini A, Marras C, Ferroli P, Bugiani O, Broggi G (2005) Stimulation of the posterior hypothalamus for medically intractable impulsive and violent behavior. Stereotact Funct Neurosurg 83:63–66
Gilbert F (2011) Working while under the influence of performance enhancing drugs: is one “more responsible”? Am J Bioeth Neurosci 2:57–59
Gilbert F (2012) The burden of normality: from ‘chronically ill’ to ‘symptom free’. New ethical challenges for deep brain stimulation postoperative treatment. J Med Ethics. doi:10.1136/medethics-2011-100044
Gilbert F (2013) Deep brain stimulation for treatment resistant depression: postoperative feeling of self-estrangement, suicide attempt and impulsive-aggressive behaviours, Neuroethics. doi: 10.1007/s12152-013-9178-8
Gilbert F, Baertschi B (2011) Neuroenhancement: much ado about nothing? Am J Bioeth Neurosci 2:45–47
Gilbert F, Ovadia D (2011) Deep brain stimulation in the media: over-optimistic media portrayals calls for a new strategy involving journalists and scientifics in the ethical debate. J Integr Neurosci 5:16. doi:10.3389/fnint.2011.00016
Gilbert F, Harris AR, Kapsa RMI (2012) Efficacy testing as primary purpose of phase 1 clinical trials: is it applicable to first-in-human bionics and optogenetics trials? Am J Bioeth Neurosci 3:20–22
Glover J (1984) What sort of people should there be? Penguin, New York
Halliday AJ, Cook MJ (2009) Polymer-based drug delivery devices for neurological disorders. CNS Neurol Disord Drug Targets 8:205–221
Hamani C, McAndrews MP, Cohn M, Oh M, Zumsteg D, Shapiro CM, Wennberg RA, Lozano AM (2008) Memory enhancement induced by hypothalamic/fornix deep brain stimulation. Ann Neurol 63:119–123
Haq I, Foote K, Goodman W, Ricciuti N, Ward H, Sudhyadhom A, Jacobson C, Siddiqui M, Okun M (2010) A case of mania following deep brain stimulation for obsessive compulsive disorder. Stereotact Funct Neurosurg 88:322–328
Harris J (2007) Enhancing evolution. The ethical case for making better people. Princeton University Press, Princeton
Heinze HJ, Heldmann M, Voges J, Hinrichs H, Marco-Pallares J, Hopf JM, Müller UJ, Galazky I, Sturm V, Bogerts B, Münte TF (2009) Counteracting incentive sensitization in severe alcohol dependence using deep brain stimulation of the nucleus accumbens: clinical and basic science aspects. Front Hum Neurosci 3:22
Hochberg L, Serruya M, Friehs G, Mukand J, Saleh M, Caplan A, Branner A, Chen D, Penn R, Donoghue J (2006) Neuronal ensemble control of prosthetic devices by a human with tetraplegia. Nature 442:164–171
Houeto JL, Mesnage V, Mallet L, Pillon B, Gargiulo M, du Moncel ST et al (2002) Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 72:701–707
Hughes J (2010) Technoprogressive biopolitics and human enhancement. In: Jonathan M, Sam B (eds) Progess in bioethics. MIT Press, Hong Kong, pp 163–188
Juengst ET, Binstock RH, Mehlman M, Post SG, Whitehouse P (2003) Biogerontology, “anti-aging medicine,” and the challenges of human enhancement. Hastings Cent Rep 33:21–30
Kennedy PR, Bakay RA (1998) Restoration of neural output from a paralyzed patient by a direct brain connection. Neuroreport 9:1707–1711
Kuhn J, Lenartz D, Huff W, Lee S, Koulousakis A, Klosterkoetter J, Sturm V (2007) Remission of alcohol dependency following deep brain stimulation of the nucleus accumbens: valuable therapeutic implications? J Neurol Neurosurg Psychiatry 78:1152–1153
Lee W, Parpura V (2009) Carbon nanotubes as substrates/scaffolds for neural cell growth (In: Sharma HS (ed) Nanoneuroscience and nanoneuropharmacology). Prog Brain Res 180:111–125
Lenk C, Biller-Andorno N (2007) Nanomedicine-emerging or re-emerging ethical issues? A discussion of four ethical themes. Med Health Care Philos 10:173–184
Macoubrie J (2005) Informed public perceptions of nanotechnology and trust in Government Woodrow Wilson International Center for Scholars, the Pew charitable Trusts. http://www.wilsoncenter.org/sites/default/files/macoubriereport1.pdf. Accessed 18 Apr 2012
Medtronic (2011) Deep brain stimulation for movement disorders. http://professional.medtronic.com/therapies/deep-brain-stimulation/index.htm. Accessed 7 Mar 2011
NeuroVista (2011) NeuroVista receives approval for expanding Australian clinical study. http://www.neurovista.com/docs/2011-01-30_PressRelease_ApprovalforExpandedTrial.pdf. Accessed 17 Mar 2011
Noda M, Vogel RL, Craig AM, Prahl J, DeLuca HF, Denhardt DT (1990) Identification of a DNA sequence responsible for binding of the 1,25-dihydroxyvitamin D3 receptor and 1,25-dihydroxyvitamin D3 enhancement of mouse secreted phosphoprotein 1 (Spp-1 or osteopontin) gene expression. Proc Natl Acad Sci USA 87:9995–9999
Nordmann A (2007) If and then: a critique of speculative nanoethics. Nanoethics 3:31–46
Olds J, Milner P (1954) Positive reinforcement produced by electrical stimulation of septal area and other regions of rat brain. J Comp Psychol 47:419–427
Partridge BJ, Bell SK, Lucke JC, Yeates S, Hall WD (2011) Smart drugs “as common as coffee”: media hype about neuroenhancement. PLoS One 6(11):10.1371/journal.pone.0028416
Phillips KA, Grant J, Siniscalchi J, Albertini RS (2001) Surgical and nonpsychiatric medical treatment of patients with body dysmorphic disorder. Psychosomatics 42:504–510
Portenoy KR, Jarden JO, Sidtis JJ, Lipton RB, Foley KM, Rottenberg DA (1986) Compulsive thalamic self-stimulation: a case with metabolic, electrophysiologic and behavioral correlates. Pain 27:277–290
Racine E, Waldman S, Palour N, Risse D, Illes J (2007) “Currents of hope”: neurostimulation techniques in U.S. and U.K. print media. Camb Q Healthc Ethics 16:312–316
Repantis B, Schlattmann P, Laisney O, Heuser I (2008) Antidepressants for neuroenhancement in healthy individuals: a systematic review. Poiesis and Praxis 6:139–174
Schlaepfer TE, Fins J (2010) Deep brain stimulation and the neuroethics of responsible publish-ing, when one is not enough. JAMA 303:775–776
Snyder DE, Echauz J, Grimes DB, Litt B (2008) The statistics of a practical seizure warning system. J Neural Eng 5:392–401
Synofzik M (2009) Ethically justified, clinically applicable criteria for physician decision-making in psychopharmacological enhancement. Neuroethics 2:89–102
Taniyama Y, Tachibana K, Hiraoka K, Aoki M, Yamamoto S et al (2002) Development of safe and efficient novel nonviral gene transfer using ultrasound: enhancement of transfection efficiency of naked plasmid DNA in skeletal muscle. Gene Ther 6:372–380
Tebbetts JB, Tebbetts TB (2002) An approach that integrates patient education and informed consent in breast augmentation. Plast Reconstr Surg 110:971–978
Tsai HC, Chen SY, Tsai ST, Hung HY, Chang CH (2010) Hypomania following bilateral ventral capsule stimulation in a patient with refractory obsessive-compulsive disorder. Biol Psychiatry 68:7–8
Turner DC, Sahakian BJ (2006) Neuroethics of cognitive enhancement. Biosocieties 1:113–123
Wilz A, Pritchard EM, Li T, Lan JQ, Kaplan DL, Boison D (2008) Silk polymer-based adenosine release: therapeutic potential for epilepsy. Biomaterials 29:3609–3616
World Health Organization (1946) Preamble to the constitution of the World Health Organization as adopted by the International Health Conference. http://www.who.int/about/definition/en/print.html. Accessed 18 Apr 2012
Wright MR (1986) Surgical addiction: a complication of modern surgery? Arch Otolaryngol 112:870–872
Wright HN (1987) Characterization of olfactory dysfunction. Arch Otolaryngol 112:870–872
Acknowledgement
This research was funded by the Australian Centre of Excellence for Electromaterials Science (ACES). Thanks to Susan Dodds, Eliza Goddard and Timothy Krahn.
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Gilbert, F. (2013). Nano-bionic Devices for the Purpose of Cognitive Enhancement: Toward a Preliminary Ethical Framework. In: Hildt, E., Franke, A. (eds) Cognitive Enhancement. Trends in Augmentation of Human Performance, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-6253-4_11
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