The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) recently released Gray Matters: Topics at the Intersection of Neuroscience, Ethics, and Society (Gray Matters, Vol. 2). This is the second volume in its two-part response to President Obama’s July 2013 Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative-related charge to “identify proactively a set of core ethical standards—both to guide neuroscience research and to address some of the ethical dilemmas that may be raised by the application of neuroscience research findings.”
Gray Matters, Vol. 2 addresses some of the ethical and societal implications of neuroscience research and its applications. For example, the Bioethics Commission thoughtfully considered ethical concerns that can accompany the development and use of new techniques and technologies to modify human neural functioning including cognitive enhancers. These “neural modifiers” include any methods, behaviors, and conditions that alter the brain and nervous system including novel technologies. Neural modifiers can serve three goals, including (1) maintaining or improving neural health or cognitive function within typical or statistically normal ranges, (2) treating neurological disorders, and (3) expanding or augmenting neural function above typical or statistically normal ranges.
The Bioethics Commission learned that clinicians often receive requests to prescribe medications for cognitive enhancement, a form of neural modification, and determined that clinicians should have access to detailed professional guidelines to help manage patient requests ethically. This guidance is especially important with regard to children and adolescent patients. Specifically, the Bioethics Commission recommended:
Professional organizations and other expert groups should develop guidance for clinicians, employers, parents, educators, and patients about the use of neural modifiers and their potential risks and benefits. Medical professional organizations should develop guidelines to assist clinicians in responding to requests for prescriptions for interventions to expand or augment neural function. Clinicians should not prescribe medications that have uncertain or unproven benefits and risks to augment neural function in children and adolescents who do not have neurological disorders.
Guidance documents from professional organizations can support the decision-making process for a diverse group of stakeholders, including clinicians, employers, parents, educators, and professional organizations in fields such as aviation, medicine, and the military that are associated with on-the-job use of brain and nervous system enhancement interventions. Guidelines should include relevant information about the ethical concerns related to the prescription and use of neural modifiers, including just distribution and access, risks and benefits, coercion and autonomy, and respect for human dignity.
Gray Matters, Vol. 2and all other Bioethics Commission reports are available at Bioethics.gov.