Neuroethics as foundational

January 28, 2020

Pär SegerdahlAs neuroscience expands, the need for ethical reflection also expands. A new field has emerged, neuroethics, which celebrated its 15th anniversary last year. This was noted in the journal AJOB Neuroscience through an article about the area’s current and future challenges.

In one of the published comments, three researchers from the Human Brain Project and CRB emphasize the importance of basic conceptual analysis in neuroethics. The new field of neuroethics is more than just a kind of ethical mediator between neuroscience and society. Neuroethics can and should contribute to the conceptual self-understanding of neuroscience, according to Arleen Salles, Kathinka Evers and Michele Farisco. Without such self-understanding, the ethical challenges become unclear, sometimes even imaginary.

Foundational conceptual analysis can sound stiff. However, if I understand the authors, it is just the opposite. Conceptual analysis is needed to make concepts agile, when habitual thinking made them stiff. One example is the habitual thinking that facts about the brain can be connected with moral concepts, so that, for example, brain research can explain to us what it “really” means to be morally responsible for our actions. Such habitual thinking about the role of the brain in human life may suggest purely imaginary ethical concerns about the expansion of neuroscience.

Another example the authors give is the external perspective on consciousness in neuroscience. Neuroscience does not approach consciousness from a first-person perspective, but from a third-person perspective. Neuroscience may need to be reminded of this and similar conceptual limitations, to better understand the models that one develops of the brain and human consciousness, and the conclusions that can be drawn from the models.

Conceptual neuroethics is needed to free concepts from intellectual deadlocks arising with the expansion of neuroscience. Thus, neuroethics can contribute to deepening the self-understanding of neuroscience as a science with both theoretical and practical dimensions. At least that is how I understand the spirit of the authors’ comment in AJOB Neuroscience.

Pär Segerdahl

Emerging Issues Task Force, International Neuroethics Society (2019) Neuroethics at 15: The Current and Future Environment for Neuroethics, AJOB Neuroscience, 10:3, 104-110, DOI: 10.1080/21507740.2019.1632958

Arleen Salles, Kathinka Evers & Michele Farisco (2019) The Need for a Conceptual Expansion of Neuroethics, AJOB Neuroscience, 10:3, 126-128, DOI: 10.1080/21507740.2019.1632972

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We want solid foundations - the Ethics Blog


Clinical cancer trials convey a culture of hope

January 14, 2020

Pär SegerdahlActivities that we may want to keep apart often overlap. An example is cancer research and care. Clinical cancer centers often conduct research and recruit patients as research participants. Such research is important if we want to offer future patients better cancer treatments. However, does this also apply to patients participating in studies? Are they offered better care as research participants?

Together with five co-authors, Tove Godskesen recently published an interview study with clinical physicians carrying out clinical cancer trials in Sweden, Denmark and Finland. The questions were about what ethical challenges the physicians perceived in the care of patients who participate in clinical trials. Does the overlap of care and research create ethical challenges? Although several physicians mentioned challenges, there were tendencies to downplay ethical difficulties and to associate the overlap between research and care with care benefit.

Tove Godskesen sees indications of a culture of hope in clinical cancer trials, where patients and physicians reinforce the image of research participation as an opportunity to access the latest therapy. However, uncertain patients can challenge the picture by asking the physician to affirm that the experimental treatment is as good as the standard treatment. You do not know that. That is why you are doing research!

The authors do not make any claims about whether a culture of hope in clinical cancer trials is good or not. However, they believe that the culture needs to become visible and discussed openly. So that the ethical challenges when care and research overlap do not disappear from sight.

The culture of hope has several aspects that you can read more about in the article. For example, the attitude that it is better to avoid giving patients bad news.

Pär Segerdahl

Tove E Godskesen, Suzanne Petri, Stefan Eriksson, Arja Halkoaho, Margrete Mangset and Zandra E Nielsen. The culture of hope and ethical challenges in clinical trials: A qualitative study of oncologists and haematologists’ views. Clinical Ethics. First Published December 30, 2019. https://doi.org/10.1177/1477750919897379

This post in Swedish

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