Thursday, October 20, 2011

Should the Skull Be an Inviolable Zone of Privacy?

Keynote Speaker Focuses on Bioethics

by Faith Reidenbach

“We are becoming cyborgs,” one of the founders of neuroethics, Dr. Paul Root Wolpe, told the large audience assembled for his keynote address on Thursday morning. He wasn’t playing on the fact that AMWA’s conference falls near Halloween this year. As an increasing number of people use artificial organs to survive, prosthetic limbs to move, or brain waves to communicate, we are becoming “semicreated creatures,” Dr. Wolpe said, and the accelerating pace of these advances “may induce a phase change beyond which we can predict nothing.”

By juxtaposing photos, Dr. Wolpe demonstrated that a real-life woman who has a brain implant for a neurologic disorder looks remarkably like Star Trek Captain Jean-Luc Picard after he was assimilated by The Borg. And just as Picard discovered when he battled the Borg Queen, “our last great freedom”—the freedom not to reveal the contents of our minds—may someday be in jeopardy. Using functional MRI, scientists at Carnegie Mellon University have taken a baby step toward mind reading:  they have shown that they can identify the unique brain activation patterns generated when a person thinks of any one of dozens of nouns. Later, with about 75% accuracy, they determined what noun a person was thinking of, even nouns their computer model had not encountered.

Dr. Wolpe explained that according to other studies, brain imaging can distinguish traits, such as extroversion versus introversion; whether a person has racist attitudes; what languages a prisoner of war can read; a person’s intentions on a very simple level—the intention to add or subtract; and whether a person is more likely than average to engage in violent behavior.

“Should the skull be an inviolable zone of privacy?” he asked. The emerging field of what he calls neuroprivacy exemplifies that ethics is much more than an inquiry into right and wrong. “Ethical consensus is a social, evolving process in which the media plays a primary role.”

Dr. Wolpe also discussed “cosmetic” neurology. Reporting that 20% of scientists acknowledge using a psychostimulant such as Ritalin, Adderall, or modafinil, he posed the question of whether use of this drug class should be required of professionals such as pilots and surgeons. Other examples of cosmetic neurology are the use of propranolol for memory suppression, research by Nobel Laureate Eric Kantel on memory enhancers, and, much more questionably, the use of oxytocin spray as a “trust inducer.” What are the ethical implications of spraying Liquid Trust on flowers given to a girlfriend?

Turning to the hot-button issue of prenatal genetic testing, Dr. Wolpe said he is not opposed, but that scientists should own up to the fact that “it’s eugenics” and talk about how to manage the consequences of the testing. For example, he pointed out, a disease such as cystic fibrosis might be cured by the time a child with the CFTR gene reaches reproductive age; should a fetus with the gene necessarily be aborted?

Medicine will become a “risk management system,” he predicted, with individuals receiving long printouts of their genetic profiles. Not all parts of the profiles will relate to disease; for example, some scientists believe there are genetic markers for criminal behavior. “What do we do with that information?”

In all of these areas, “the science is running way ahead of the ethics,” Dr. Wolpe said. The goal should not be to hurry to arrive at cut-and-dried decisions; rather, what’s needed are “robust ethical conversation with people representing different points of view.”

Dr. Wolpe encouraged listeners to visit the home page of the Center for Ethics at Emory University, which he currently directs. At Emory he is the Asa Griggs Candler Professor of Bioethics; Raymond Schinazi Distinguished Research Professor of Jewish Bioethics; and professor of medicine, pediatrics, psychiatry, neuroscience and biological behavior, and sociology. Dr. Wolpe also serves as the senior bioethicist at NASA (National Aeronautics and Space Administration). He is co-editor of the American Journal of Bioethics (AJOB) and editor-in-chief of AJOB‒Neuroscience. He sits on the editorial boards of more than a dozen professional journals in medicine and ethics. Dr. Wolpe is a past president of the American Society for Bioethics and Humanities, a fellow of the Hastings Center, and a fellow of the College of Physicians of Philadelphia, the country’s oldest medical society.

Related Links
Dr. Wolpe's Web page
Dr. Wolpe on "60 Minutes"

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