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Neuroethics

Neuroethics of Neurological of Treatments

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Neuroscience has led to a deeper understanding of the chemical imbalances present in a disorder brain. In turn, this has resulted in the creation of new treatments and medications to treat these disorders. When these new treatments are first being tested, the experiments prompt ethical questions. First, because the treatment is affecting the brain, the side effects can be very unique and sometimes severe. A special kind of side effect that many subjects have claimed to experience in neurological treatment tests is changes in “personal identity”. Although this is a difficult ethical dilemma because there are no clear and undisputed definitions of personality, self, and identity, neurological treatments can result in patients losing parts of “themselves” such as memories or moods. Yet another ethical dispute in neurological treatment research is the choice of patients. From a perspective of justice, priority should be given to those who are most seriously impaired and who will benefit most from the intervention. However, in a test group, scientists must select patients to secure a favorable risk-benefit ratio. Setting priority becomes more difficult when a patient’s chance to benefit and the seriousness of their impairment do not go together. For example, many times an older patient will be excluded despite the seriousness of their disorder simply because they are not as strong or as likely to benefit from the treatment. The main ethical issue at the heart of neurological treatment research on human subjects is promoting high-quality scientific research in the interest of future patients, while at the same time respecting and guarding the rights and interests of the research subjects. This is particularly difficult in the field of neuroscience because damage to the brain is often permanent and will change a patient’s way of life, forever.

Neuroethics and disorders of consciousness

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Patients in coma, vegetative, or minimally conscious state pose ethical challenges. They are unable to communicate their pain levels, quality of life, or end of life preferences, therefore, the patient’s needs can only be assessed by adopting a third person perspective. Neuroscience and brain imaging have allowed us to explore the brain activity of these patients more thoroughly. Neuroimaging research could eventually improve the accuracy of diagnoses and prognoses of patients with disorders of consciousness. Furthermore, recent findings from studies using functional magnetic resonance imaging have changed the way we view vegetative patients. The images have shown that aspects emotional processing, language comprehension and even conscious awareness might be retained in patients whose behavior suggests a vegetative state. If this is the case, it is unethical to allow a third party to dictate the life and future of the patient. For example, defining death is an issue that comes with patients with severe traumatic brain injuries. The decision to withdraw life-sustaining care from these patients can be based on uncertain assessments about the individual’s conscious awareness. Case reports have shown that these patients in a persistent vegetative state can recover unexpectedly. This raises the ethical question about the premature termination of care by physicians. The hope is that one day, neuroimaging technologies can help us to define these different states of consciousness and enable us to communicate with patients in vegetative states in a way that was never before possible. The clinical translation of these advanced technologies is of vital importance for the medical management of these challenging patients. In this situation, neuroscience has both revealed ethical issues and possible solutions.

Neuroethics and free will

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A crime in the United States requires a “guilty act” and a “guilty mind”. As neuropsychiatric evaluations have become more commonly used in the criminal justice system and neuroimaging technologies have given us a more direct way of viewing brain injuries, scholars have cautioned that this could lead to the inability to hold anyone criminally responsible for their actions. In this way, neuroimaging evidence could suggest that there is no free will and each action a person makes is simply the product of past actions and biological impulses that are out of our control.

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References

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  1. ^ Aggarwal, Neil Krishan; Ford, Elizabeth (2013). "The Neuroethics and Neurolaw of Brain Injury". Behavioral Sciences & the Law. 31 (6): 789–802. doi:10.1002/bsl.2086. PMID 24123245.
  2. ^ Schermer, Maartje (2011-5-09). "Ethical Issues in Deep Brain Stimulation". Frontiers in Integrative Neuroscience. 5: 17. doi:10.3389/fnint.2011.00017. PMC 3096836. PMID 21625629. {{cite journal}}: Check date values in: |date= (help)
  3. ^ Bruno, Marie-Aurelie (2013). "Coma and disorders of consciousness". Handbook of Clinical Neurology. 118: 205–213. doi:10.1016/B978-0-444-53501-6.00017-2. ISBN 9780444535016. PMID 24182379. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)