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Stanford Report, May 22, 2002

First-of-its-kind neuroethics event covers new turf

By AMY ADAMS

What is normal? Can brain scans distinguish between true and false memories? Is it OK to give a drug or insert a brain implant to treat criminal behavior? Those were some questions posed by neuroscientists, ethicists, lawyers and philosophers at the first-ever neuroethics conference. Co-organized by Stanford University Medical Center and UC-San Francisco, the meeting took place last week at the Golden Gate Club in San Francisco.

"What happens in brain science in the next 25 to 30 years will be as important as what has happened in genetics in the past 10 years," predicted Zach Hall, chairman of the conference and an adviser to the New York-based Dana Foundation, which sponsored the event. Hall hopes bringing ethicists and researchers together will help lay the groundwork for how to proceed ethically. "The conference was meant not to answer questions but to stimulate new questions," he said.

Some of the issues raised at the meeting revolved around drugs such as Ritalin, which may be overused by parents hoping to give their kids a boost in school. Other drugs in development can provide jitter-free, bright-eyed alertness for workers even after many hours without sleep, giving businesses a potential advantage over competitors.

Researchers at the meeting were divided over these so-called enhancement drugs. "The means we use to achieve our ends have value," said Eric Parens, PhD, associate for philosophical studies at the Hastings Center. Parens argued that it's valuable to achieve goals by working through obstacles such as focus and discipline, rather than by taking drugs.

On the other hand, Arthur Kaplan, PhD, professor of molecular and cellular engineering and of philosophy at the University of Pennsylvania, observed that people already take steps to get ahead with means other than drugs. Parents send their kids to test-preparation classes for improved scores, better college opportunities and ultimately more success. He asked the audience where the difference lies between expensive tutoring vs. medicinal learning aids.

Meeting organizers say that the conference was intended to help neurologists and ethicists hammer out the language and thinking that will influence this budding field. "It's no longer enough that ethicists sit in their offices thinking about problems and neurologists sit in their labs creating them," said William Mobley, MD, PhD, John E. Cahill Family Professor in the School of Medicine. "They have to work together to figure out what is appropriate." Mobley was a meeting organizer and speaker.

Neurologists' research about how the brain functions and develops has helped spawn some of the debate. "How will our new understanding make us feel about addiction or aggression?" Hall asked.

Research has revealed, for example, that many violent criminals had brain injuries in their youth. "A person's behavior is affected by things that the legal system needs to take into consideration," said William Winslad, PhD, JD, professor of philosophy in medicine at the University of Texas Medical Branch in Galveston. He added that a brain injury won't free a person from responsibility, "but at least there would be a basis for assessing how much control a person had."

Barbara Koenig, associate professor of pulmonary and critical care and executive director of Stanford's Center for Biomedical Ethics, said people have been thinking about these issues for years. "We're having the conference to bring together these leaders," said Koenig, who also chaired a session on brain science and social policy. She added that each session was designed as a conversation, with a neurologist, ethicist and legal or philosophy expert bringing their unique perspective to a given topic.

Other speakers from Stanford included Judy Illes, PhD, senior research scholar at the center for biomedical ethics, and Henry Greely, JD, professor of law.




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Stanford University Center for Biomedical Ethics