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VIEW Open Access Neuroethics: the Pursuit of Transforming Medical Ethics in Scientific Ethics Gustavo Figueroa*

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VIEW Open Access Neuroethics: the Pursuit of Transforming Medical Ethics in Scientific Ethics Gustavo Figueroa* Figueroa Biol Res (2016) 49:11 DOI 10.1186/s40659-016-0070-y Biological Research REVIEW Open Access Neuroethics: the pursuit of transforming medical ethics in scientific ethics Gustavo Figueroa* Abstract Ethical problems resulting from brain research have given rise to a new discipline termed neuroethics, representing a new kind of knowledge capable of discovering the neural basis for universal ethics. The article (1) tries to evaluate the contributions of neuroethics to medical ethics and its suitability to outline the foundations of universal ethics, (2) critically analyses the process of founding this universal ethic. The potential benefits of applying neuroimaging, psy- chopharmacology and neurotechnology have to be carefully weighed against their potential harm. In view of these questions, an intensive dialogue between neuroscience and the humanities is more necessary than ever. Keywords: Neuroethics, Free will, Mind-body problem, Neuroscience Background Origin of neuroethics Toulmin provocatively postulated that medicine saved Medicine emerged in Greece as a profession, that is, a Western ethics from its implicit, although increasingly professio, which has a religious origin: to profess is an act decadence product of academic discussions with little that demands delivering, an activity that demands com- concrete value for the lives of human beings, when creat- mitting one’s self entirely and for life. It is a kind of con- ing bioethics based on the urgency of physicians at the secration and those who exercise it are consecrates [7, 8]. bedsides of their patients [1]. Despite his astute reflec- From this the Hippocratic “Oath” was born at the dawn- tion, he did not consider two aspects. Firstly, beginning ing of medicine (tekhné iatriké) around the fifth century in the 1960s, philosophy made an important ethical B.C. and consequently every physician is committed not shift as a result of a “rehabilitation of practical philoso- only to executing his/her techniques well, but also to pro- phy”, which means a priority on the practical, immedi- fess a moral. This moral is not just any, but rather is one ate and factual [2, 3]. On the other hand, medical ethics that tends toward perfection or excellence (areté) and the has a long history that it has never abjured; moreover, it doctor is a special person because he/she seeks to con- has always constituted the first foundation of medicine’s duct a virtuous life. The moral perspective has accompa- ends, theories and practices, and continues to be in full nied us continuously throughout history, in completely force significantly in the twentieth century [4–6]. distinct civilizations like the Hindu, Jewish, Arabic and The present work has three objectives. The first is to Chinese. This means that the raison d’être of the moral outline the birth of neuroethics from the ethical tradition perspective is so deep and so deeply rooted in our tradi- of medicine. The second is to consider the main achieve- tion that any person that takes up its exercise is required ments, advances and future perspectives of neuroethics, to begin with a strict and solemn ritual, that of taking an and the third is to discuss the foundations underlying this oath, real or symbolic, of respect and obedience [9–11]. new way of understanding medical morals. The situation changed dramatically after the first half of the twentieth century and in a short time bioethics burst forth, imposed itself and spread with unstoppable force; *Correspondence: [email protected] despite the numerous investigations dedicated to its gen- Departamento de Psiquiatría, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile esis—medical, legal, economic, historical, philosophical-, © 2016 Figueroa. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:// creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/ zero/1.0/) applies to the data made available in this article, unless otherwise stated. Figueroa Biol Res (2016) 49:11 Page 2 of 7 there has not yet been a satisfactory elucidation of the has moved it with growing force in the beginning of the motives that provoked this revolution that definitively 19th century, the essence of human beings lies in their upset the way in which medicine is practiced. In short, primarily biological condition and empirical data is prov- there is a before and an after of this event [12–14]. With ing that it is the gene where the ultimate truth lies. a bilocated birth, ecological bioethics, headed by Van The situation changed and again explosively when in Rensselaer Potter [15] and medical bioethics, guided by May 2002, 150 biologists, neuroscientists, physicians, André Hellegers and Daniel Callahan [16, 17], followed lawyers, psychologists, and sociologists met in San Fran- the proposal of the cancer specialist Madison: “As a new cisco and proclaimed, in the words of the journalist and discipline….combines biological knowledge with knowl- organizer William Safire, that neuroethics had been edge of the systems of human values” [18]. Its objective born and that it was characterized as “the study of ethi- was ambitious, to bridge two modes of understanding cal, legal and social questions that emerge when scien- the condition of human illness based on biological sci- tific discoveries about the brain led to medical practices, ences and the humanities and its values. Its spectacular legal interpretations and health and social policies” [22]. expansion exceeded any prediction and in a few years it It was concluded that neuroscience and its technology compromised not only medicine in its totality, but also had progressed with such vigor that encompass, drive, law, economy, philosophy and politics. Three attributes configure and determine decisively the different areas of characterize its growth when applied to human illness: to human activity—art, philosophy, law, economics, theol- elaborate specific procedures that serve to guide medical ogy, medicine. A century ago Husserl firmly maintained action in its very diverse fields; a particular concern about that “there is no idea more powerful and whose advance its application with the aim that it not remain in dead let- is more irresistible than that of science …, nothing can ters, because of which it was necessary to recommend stop its triumphal march” [23]; now neuroethics reaffirms sanctions in cases of negligence or abuse; and developing it with propriety and feels authorized to assert that it is certain principles sufficiently general that they can serve empirical science that can and should provide the fun- as the basis for ordering behavior and taken in account damental responses and basic truths about the place of requires acceptance by all members in order to aspire to humans in the cosmos. In this it is similar to GenEthics, universal in an axiological and polytheistic society like but from there also differences emerge. While GenEth- that of today [19]. In other words, foundations, systems ics reminds us of the potential dangers, it promotes the of prescriptions or procedural guides and regulated and regulation of its actions and elaborates strict precaution- effective sanctions. ary protocols (which have been becoming progressively Despite the coincidence in time, the situation was very more flexible over time), Neuroethics raises as an inal- different from the ethical problems resulting from the ienable right to investigate without limits or hindrance, biotechnological revolution: uncertainty, risk and danger. has as a goal to provide the scientific basis of the ethic In the early 1970s, the revolutionary cellular and animal supported in empirical findings and assumes among its virus research began to show its misty and ominous face: tasks that of modifying the human essence, or some its the growing threat to which researchers were exposing features, according to advances in research. Neurophi- the entirety of humanity. Alarms went off vividly, recall- losophy emerged with unusual speed as a result of its ing the words of Oppenheimer after the fateful nuclear proposals and in consonance with them burst forth neu- tests, “physicists have known sin and this is a knowl- rophilosophy, neurotheology, neuropolitics, neuroeco- edge which they cannot lose” [20]. It was in June 1973 nomics, neuroaesthetics, neuroeducation, just to name and again from February 24–27 in 1975 at the Asilomar the main disciplines, novice disciplines that have placed conferences on the risks of recombinant DNA that, after traditions in check and obliged them to rethink under heated discussion, safety guidelines were approved with threat of being relegated to the past. two types of protective barriers, biological and physical, and four levels of risk. With what was termed the “pre- The neuroethics project cautionary principle” and the certain awareness that the In 2002 Roskies proposed dividing the field into two manipulation of genetic material is always done in the branches that, although intimately connected, are dis- context of uncertainty, GenEthics was born. Its main con- tinct and require being differentiated in order to refine clusion, unprecedented as it had never been expressed
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