2019 Annual Meeting Chicago, IL, USA October 17-18HighlightsProgramPublic EventPresentationsSponsorsMapping Neuroethics: An Expanded VisionThe 2019 Annual Meeting of the International Neuroethics Society (INS) gathered a diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science. Attendees participated in intellectually stimulating and dynamic sessions that explored neuroethics in a global context.Meeting program lists all sessions and confirmed speakersSubscribe to receive email updates about future meetings Sponsors    Overviews PreviewsDana Foundation guest blog post by Elaine Snell: International Neuroethics Society Annual Meeting in Chicago, Oct. 17-18Interview with Program Committee co-chairs Ilina Singh and Arleen Salles: The INS annual meeting brings together people from around the world with shared goals in neuroethics Meeting PhotosMany thanks to Gillian Hue for capturing key moments from the annual meeting. Several great photos are available at the bottom of this page. Other photos from the meeting are available upon request for personal or professional use. Contact staff by email (administrator@neuroethicssociety.org) with your requests. Please be sure to credit Gillian Hue when sharing photos online. Plenary Speakers FRED KAVLI DISTINGUISHED NEUROETHICS LECTUREMartha J. FarahCenter for Neuroscience & Society University of Pennsylvania Lecture: ‘Socioeconomic status and brain development: from science to policy’Article: Martha Farah on the Impact of SES (Dana Foundation)Interview: The brain and socioeconomic status: how do we apply it to real-world policy?  OPENING PLENARY SPEAKERMatthew L. BaumHarvard Medical School Lecture: ‘The Neuroethics of Biomarkers’Interview: Neurotechnology produces a better diagnosis, but what are the ethical implications for people with mental illness? Sessions Solving Dilemmas in Global NeuroethicsPresentations and a follow-up world cafe discussion with the full audience examined several themes addressed in the perspective article, ‘Neuroethics Questions to Guide Ethical Research in the International Brain Initiatives‘ (Neuron, 2018). The goal of this session was to promote a productive dialogue on diverse ethical approaches to contemporary issues in global neuroethics. Ethics and the Imprisoned BrainAs researchers begin to investigate techniques for altering inmates’ brains to rid prisons of what Anthony Burgess called ‘the ultra-violence,’ the ongoing neuroethics discourse about biological approaches to criminal justice takes on renewed urgency. Speakers addressed the promise and peril of neuro-interventions for incarcerated persons, whether in research and development or implementation and oversight. Interview with session moderator Roland Nadler: Neuroscience May Help Curb Prison Violence – But Should It? Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?Session summary by Ian StevensInterview with session moderator Jennifer Chandler: Working at the Intersection of Brain Science, Law and Ethics Preclinical Interventions in Psychiatric and Neurological DisordersAs we get better at using genetic, metabolic or behavioral biomarkers to predict future susceptibility for neurological and psychiatric syndromes, the problem of medical management of people in such preclinical states becomes more trenchant. Testing preventive drugs, informing patients or parents of risks, managing false positives, and treating patients with little discernible illness raise significant ethical questions that were discussed with a panel of experts. Disorders of Consciousness: Concepts, Culture and PrognosisSession summary by Ian Stevens SUMMARIESMartha Farah honored for her service to the field of neuroethicsMartha Farah, the Walter H. Annenberg Professor in Natural Sciences and professor of psychology at the University of Pennsylvania, is the 2019 winner of the Steven E. Hyman Award for Distinguished Service to the Field of Neuroethics.Professor Farah has degrees in metallurgy and philosophy from Massachusetts Institute of Technology and a PhD in psychology from Harvard University. Now she is a cognitive neuroscientist and her research focusses on socioeconomic status (SES) and brain development. SES is linked to the way we think and solve problems and to our well-being and mental health. She is a founding director of the Center for Neuroscience and Society at the University of Pennsylvania. Professor Farah was also one of the founders of the International Neuroethics Society.Steve Hyman, awardee Martha Farah, Hank Greely, Nita Farahany and Judy Illes.The INS established the Steven E. Hyman award in 2016 to recognize people who have helped develop the field of neuroethics and who have contributed to the INS. The INS President, Immediate Past President, and President-Elect select the recipient.Professor Hank Greely, now the INS Immediate Past-President, said, “Martha has been part of the INS since it was established in 2006. She has played a crucial role within the INS, and in neuroethics more generally outside the INS.”Presenting the award at the INS annual meeting in Chicago on Friday, October 18, Professor Steve Hyman, for whom the prize is named, said, “We are delighted to present this award to Martha Farah, a world-leading cognitive neuroscientist. Her pioneering work on the link between poverty and children’s brain development is neglected by the neuroscience community, and yet her research is what neuroethics should be about.”Receiving the award, Professor Farah said, “I feel very honored by this award, named for one of my neuroscience and neuroethics heroes. I am also very grateful to the INS leadership, who have done so much to advance the understanding of ethics in neuroscience. Their approval means a lot to me!”Should we trust technology to provide mental health care?The public program, organized by the International Neuroethics Society in conjunction with Northwestern University, examined the potential challenges and opportunities associated with digital mental health care. Based upon our increased reliance on technology, can we trust technology to supplement, or eventually substitute, human health care providers?Public program meeting room at the Daniel Hale Williams Auditorium at Northwestern UniversityMental illness accounts for approximately one-third of global adult disability (Lake, 2017). The number of individuals diagnosed with mental health disorders continues to increase worldwide, with a substantial proportion of individuals failing to receive any treatment. In the United States, approximately 1 in 4 adults suffer from a diagnosable mental health disorder, and 44.7 million U.S. adults were diagnosed with a mental health disorder in the last year, with only 43 percent receiving mental health treatment. Moreover, approximately 10.4 million U.S. adults were diagnosed with severe mental health disorders, such as major depressive disorder, anxiety disorders, bipolar disorder, schizophrenia, and substance use disorders, but only 6.7 million received treatment. Worldwide, more than 70 percent of individuals with mental illness do not receive mental health treatment (Henderson et.al, 2013). Mental health services are often unavailable or underutilized in developed countries. There are several barriers to receiving mental health services, including lack of knowledge to identify characteristics of mental illnesses, stigmatization of those with mental illness, and the expectation of discrimination against those diagnosed with mental illness.Digital Mental Health Technology: The Potential to Improve Quality and Access of Mental Care Nicole Martinez-Martin, Stanford School of MedicineNicole Martinez-Martin highlighted the great potential of digital technology to improve the quality and overall use of mental health care. There has been significant investment in mental health startups, with the mental health sector receiving a record-breaking $602 million in funding last year. Approximately 77 percent of mental health startups companies were focused on mobile applications. These mobile applications are not only intended for clinical use, but for consumer use as well. However, actual consumer use can trail behind health technology innovation. Although many people may use the internet and mobile health applications for wellness and information gathering, very few use it to interact with their health care provider or insurance company, a survey by Kaiser Family Foundation found. Some ethical challenges associated with digital mental health therapy include safety/accuracy, privacy, accountability, bias/fairness, informed consent, transparency, incidental findings, and the therapeutic alliance.She also emphasized the importance of trust in health care and technology. The concept of trust, often invoked but not necessarily explored, is multi-dimensional and heavily dependent on context. Trust invokes relational obligations and vulnerability, in which an individual must place their trust in another individual or entity to further their interests. These relational obligations are heavily observed in the healthcare context, as trust can manifest in the patient–physician relationship and within interactions with healthcare institutions. In discussing digital mental health technology, trust is heavily associated with the trustworthiness of technology companies. In terms of mental health therapy, trust and trustworthiness are inextricably linked to ethical care. Some major dimensions of trustworthiness in mental health therapy include disclosure, confidentiality, dignity, continuity of care, safety avoidance, treatment effectiveness, and avoidance of stigma and coercion. These perceptions of mutual trust are crucial to the therapeutic relationship.These applications can be used as a platform for connecting with clinicians, licensed therapists, life coaches, or peers. Some forms of mobile applications include wellness apps (e.g., meditation, information for self-guided care), mood-tracking (self-monitored or monitoring by a physician), medication information/tracking, or conversational agents. It matters whether mobile applications are used within clinical or consumer domains. Whereas clinical domains require information confidentiality under HIPPA, consumer domains have been described as the ‘wild west’ with regard to data protections. Different ethical obligations will be imposed depending on the given context in which mobile applications are used. Individuals who use these mobile applications may not be aware of the behavioral inferences that can be drawn from information and its potential repercussions. Given the large demand for data, personal health information can be generated outside of HIPAA protections, exposing consumers to privacy breaches.Due to the complex nature of mental and psychological illnesses, interventions will require multifaceted approaches. Digital mental health technology has the potential to deliver mental health care on an unprecedented scale, supplementing care to provide more comprehensive mental health interventions. Digital mental health technology could potentially resolve the challenges associated with traditional mental health care, bridging any gaps in mental health treatment. She recommended that digital mental health therapy be deployed in an accountable, fair, and transparent manner and that oversight and protections must be considered for both patient and consumers alike.Being Human: A Challenge for Mental Health Digital Interventions Ilina Singh, University of OxfordApproximately 1 in 3 individuals worldwide have a mental health illness. Those living in developed countries often receive little to no treatment. Dr. Singh began by explaining her current empirical study focusing on early intervention in psychosis (EIP). The early intervention psychosis program is suited towards those who experiencing symptoms of psychosis for the first time and younger individuals with at-risk mental states. The early intervention paradigm focuses on the early identification and treatment of younger pre-symptomatic individuals who are at high risk of developing their first psychotic episode.The study employed a virtue ethics framework, finding that: negative moral self-understandings have significant consequences for the potential for recovery; EIP services are linked with ‘moral mastery’ and more positive moral self-understandings; and talking and listening is fundamental to good practice and can lead to more positive moral self-understandings. This third finding led to another important question: what ethical challenges exist in replacing mental health therapists for digital applications? The empirical data consistently indicates that the therapeutic relationship itself is strongly associated with successful patient outcomes. These psychotherapeutic benefits emerge from storytelling, which is a crucial component of the intervention process. The ability to express one’s personal story is fundamental to self-understanding and self-reflection. Through storytelling, many people gain vital insight into their lives that can lead to direct behavioral change and thus vast improvement in their quality of life.Her presentation later examined the future role, or lack thereof, of human specialists in digital mental health interventions. Since the therapeutic relationship is grounded upon human interaction, what would be the implications for digital mental health interventions, where there is no active human component? Dr. Singh describes the therapeutic relationship is a uniquely human encounter. Are human beings required for digital mental health interventions? Could artificial intelligence (AI) stand in for humans in the digital mental health clinical encounter? If so, how ‘human’ should the AI be? Human interaction is not required for every mental health intervention. AI could serve to be more useful than humans in mental health intervention in terms of efficiency, errors, and bias. In contrast, human interaction could be more preferable for treatment of mental disorders that cause feelings of inhumanness, such as psychosis. Is it possible to build ‘good-enough’ AI interventions? If so, how would the ‘good-enough’ AI interventions be distributed?Digital Mental Health David C. Mohr, Northwestern UniversityDr. Mohr’s presentation focused on the application of personal sensing — or digital phenotyping, which involves harnessing digital fingerprints from personal digital devices to understand behavior — to digital mental health interventions. Given their widespread ownership and diverse usage, smartphones can be used as a lens to predict mental status and understand behaviors related to mental health. However, a major issue with mobile health applications, which are largely feedback devices, is low data input from users. He advocates for the development of simple mobile applications that nudge behavior in positive directions, a marked departure from the concept of creating specific mobile applications for each mental health disorder. Several randomized controlled trials suggest that the outcomes received through digital mental health interventions mirror that received through traditional interventions, such as pharmacotherapy or psychotherapy. Some challenges associated with digital health interventions include low patient acceptance and lack of integration into care systems.The design of current digital mental health intervention is heavily based on psychotherapy. The translation of psychotherapy into a digital platform, he argues, is fundamentally wrong since it undermines the therapeutic alliance. There are several inherent weaknesses to digital mental health applications. Data can be extremely revealing, and consumers often cannot effectively manage their privacy. Many of these applications do not have robust privacy policies in place to protect users. Additionally, most mental health applications do not have review processes, and many are not evidence-based or based on sound psychological principles.He asserts that society is on the cusp of a technological revolution with digital mental health interventions, due to its potential cost effectiveness and ability to increase access to mental health treatment. For this to occur, however, there needs to be marked paradigm shift in mental health conceptualizations. He recommends that app developers and health systems collaborate with patients and experts from other disciplines to examine how personal sensing can be safely integrated into clinical practice.Summary written by Kimberley GloverIncapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?Many laws define psychosurgery to include deep brain stimulation (DBS) for psychiatric indications, a field under intensive exploration and expansion. This session considered the history, present and future, of the regulation of invasive psychiatric neuromodulation such as DBS, with particular attention to the questions of whether there is a need for specific law, and what its optimal contents should be.Laura Cabrera, Michigan State University (USA)Lauren Sankary, Cleveland Clinic (USA)Eran Klein, Oregon Health & Science University / University of Washington (USA)Moderated by Jennifer Chandler, University of Ottawa (Canada)Professor Jennifer Chandler introduced the panel and started the conversation by describing how her interests for psychiatric neurosurgery started when discovering the varying procedures and legalities for obtaining informed consent for psychosurgery around Canada, Australia and the United States. She asked how the cultural understandings of psychiatric neurosurgery might have originally prompted these laws and if such laws are protecting patients or hindering their access to these vital treatments.Dr. Laura Cabrera started the panel by stating her goal was originally in line with Professor Chandler’s question of understanding whether psychiatric neurosurgery ought to be regulated. Understandably this question has intrinsic importance given the risk of personality modifications with psychosurgery. She cited a 1949 article that articulated how the medical community should regulate themselves on the use of these procedures, given their thorough knowledge of it. However, this stance gradually changed through the later parts of the 20th century following abuse of psychosurgery and other medical research studies. This prompted intervention by the courts to mandate complete disclosure of the pros and cons of psychosurgery to the patients and around limitations on who could give consent following such disclosures (i.e. those without reasonable levels of autonomy). Specifically, regarding the second concern, the courts pressed that those with psychiatric disorders were likely incompetent to make an informed choice or independent autonomous decision due to their current residence in a mental healthcare facility and the possible effects of coercion. Dr. Cabrera described that Oregon was the first to set actual standards of consent for psychosurgery.She also questioned the notion of defining ‘procedure(s)’ within the law, as only six states with legal regulations on psychosurgery defined this term and that even these definitions were too ambiguous and includednoninvasive neural stimulations within their definitions. She stressed that this definition may improve with narrowing to invasive practices and by following prior recommendations for institutional review board or regularity oversight for these procedures with high standards for informed consent. Dr. Cabrera concluded her talk by highlighting the lack of enforcement for these procedures when considered or performed outside of the established guidelines. She stressed the need to develop more rigorous ethical protocols to guide the use of such therapies outside established patient populations in a way that does not overly limit their potential benefit to other patients.Lauren Sankary, JD, focused the conversation of psychiatric neurosurgery to those procedures conducted in the research setting for deep brain stimulation (DBS). She described her own research surrounding the end of trial research procedures with these neurostimulation devices. She drew questions about the implicit ambiguity and ethical weight given to DBS for a psychiatric disorder over more classic and neutral disorders like Parkinson’s disease. She then posited her main ethical concerns of therapeutic misconception with trial enrollment, continued care for patients following completion of research trials (i.e. still utilizing the implanted neurostimulation device), and the possibility of creating a vulnerable patient population following neurostimulation due to compromised neurophysiological networks necessary for autonomy. To address the first concern, she recommended future empirical neuroethical research to quantify the characteristics of vulnerability to better discover what aspects might be best improved through regulation. Regarding the second ethical concern, she had wanted to understand the ethical obligations of researchers towards continued care. She found, through her prior research, the need for researchers to maintain a level of autonomy, free of coercion, to participants by allowing and providing access to neurostimulation device removal. This was contextualized by the qualitative findings about how patient’s felt overwhelmed by the shear amount of information provided to understand at the onset of the trials. Also realized through this research was the uncertainly when researcher responsibilities end following the completion of the trial and how the difficulty of institutional review boards to enforce researcher responsibility compounds the issue. She provided patient feedback containing concerns about who would support their continued use of the devices and a feeling of being disconnected from the researchers they had established a professional relationship with through the trial. She concluded the presentation by highlighting the ambiguity within DBS end-of-trial procedures on matters of autonomy and justice, but didn’t stress the need for further regulation.Lauren Sankary, Laura Cabrera, Jennifer Chandler and Eran KleinWrapping up the panel was Dr. Eran Klein. He introduced his presentation and after a brief introduction of DBS he asked about the future concerns of psychiatric neurosurgery. He drew from the development of the ethical questions for DBS over the past century and specifically addressed an article articulating the seven common trends of these questions. He blended these trends with qualitative data from patient experiences he had collected with the Neuroethics Thrust at the Center for Neurotechnology. The first topic of ethical oversight stressed continued review of DBS research procedures, namely Institutional review boards. However, Dr. Klein reported a patient feeling that the Institutional review board was present for protection of the intuition rather than the individual participants. The second topic surrounded experience and interdisciplinary teams, and relates largely to clinical effectiveness; however, Dr. Klein posited the concerns about resource scarcity with such important treatments being focused in condensed locations. The third and fourth ethical concerns related to patient selection, which was defined as the need for strict enrollment criteria with high-risk trials, and also the overall obligations of researchers to provide participants with continued care. Similar to how Sankary stressed in the in her talk, a patient interviewed by Dr. Klein described the researcher’s ethical obligations to him and his health because they were about to put this device in his head. The fifth ethical concern involved conditions of informed consent to determine topics like decisional capacity or desperation. However, almost paradoxically, Dr. Klein highlighted how with the advanced levels of depression required for enrollment in some DBS trials, that the topic of desperation was brought up often since most patient’s already saw this as their ‘last hope’ of a therapeutic improvement. The two final topics included social responsibility, such as using research practically and therapeutically, and scientific practices, or the need for high standards of academic rigor.Dr. Klein shifted his presentation towards future developments with neurotechnology including patient control of medical devices where, for example, Bluetooth could allow more remote access to neural or medical data by providers. These could one day include medical information that is downloadable and able to be sent to providers for convenience, while at the same time increasing the ethical concerns of misdiagnosis and data security. A second future development he discussed regarded increasing levels of customizability of neural devices that would then allow patients to make their own neural adjustments. Importantly, Dr. Klein noted that in such a scenario the acceptable range of neurostimulation would still need to be determined. He also noted how some patients he interviewed were skeptical of such control out of concern for developing addiction-like behaviors. Finally, he noted future advances in DBS may continue to utilize a closed-loop DBS design where the devices function is almost entirely independent of the patient and clinician. In closing, he described that with closed-loop DBS devices the patient–clinician relationship may become unnecessary through the duration of treatment. He described this situation as: “why have an apple a day [to keep the doctor away} when you could have machine learning ?” Lastly, he articulated the interesting neuroethical questions about closed-loop DBS devices used tangentially, with the family’s feedback, and how that patient’s identity is perceived both by themselves and their loved ones. As these topics mature, and technological advances become crystalized, more subtle ethical questions may emerge.Summary written by Ian StevensWorks cited:Bell, Emily, and Eric Racine. “Ethical Guidance for the Use of Deep Brain Stimulation in Psychiatric Trials and Emerging Uses: Review and Reflections.” In Deep Brain Stimulation: A New Frontier in Psychiatry, edited by Damiaan Denys, Matthijs Feenstra, and Rick Schuurman, 273–88. Berlin, Heidelberg: Springer, 2012. https://doi.org/10.1007/978-3-642-30991-5_25.”Guideline Detail | American Academy of Neurology.” Accessed October 29, 2019. https://www.aan.com/Guidelines/home/GuidelineDetail/926.”Neuroethics | Center for Neurotechnology.” Accessed October 30, 2019. http://centerforneurotech.org/research/neuroethics.Schiff, Nicholas D. “Cognitive Motor Dissociation Following Severe Brain Injuries.” JAMA Neurology 72, no. 12 (December 1, 2015): 1413–15. https://doi.org/10.1001/jamaneurol.2015.2899.Disorders of Consciousness: Concepts, Culture and PrognosisThis session explored the importance of concepts when addressing disorders of consciousness. Speakers discussed the cultural dimensions and ethical implications of selecting concepts, how concepts can impact practice protocol and medical decision-making, and the potential consequences of categorizing patients.Speakers included:Joseph J. Fins, Weill Cornell Medical College (USA)Laura Specker Sullivan, College of Charleston (USA)L. Syd M Johnson, Michigan Technological University (USA)Moderated by Hannah Maslen, University of Oxford (UK)Dr. Hannah Maslen introduced the panel by first questioning the underlying importance of having different concepts and terms to describe a patient’s level of consciousness within medicine. She answered her rhetorical question by pointing to its importance on the diagnostic spectrum to accurately describe a patient’s level of awareness but also on a prognostic level to generally predict their chance of recovery. However, her answer was ambiguous, as she questioned if contemporary concepts of consciousness accurately performed these tasks or if modification was needed to provide further clarity. She also emphasized the capacity of these concepts to account for unknown risk, given the general difficulty in diagnosing a patient’s level of awareness given its subjective nature.Dr. Joseph J. Fins began his presentation by emphasizing the historical context of disorders of consciousness and the development of today’s American Academy of Neurology (AAN) practical guidelines from the prior forty years of academic rigor. Such developments occurred through interdisciplinary discussions between the AAN and American College of Rehabilitative Medicine, among others, to call for improved diagnostic imaging and management of co-morbidity complications in these patient’s recovery. Dr. Fins emphasized the shift in diagnostic nomenclature from describing patients in a permanent vegetative state to those in a persistent or chronic vegetative state and the significant difference in prognostic implications this had. Importantly, he noted how permanent nosology implied a prognosis while persistent indicated a diagnosis. Dr. Fins notes the hesitancy of previous scholars to grant higher levels of awareness that was clinically undeterminable. However, the understanding of these terms was only compounded by contemporary developments in neuroimaging where the patients may present minimal awareness, but their neural activity is paradoxically active. This, what was later termed cognitive motor dissociation, complicated the diagnostic picture by expanding the assessment criteria beyond simply behavioral assessments. Unfortunately, he cites the prominence of inaccurate diagnoses when incorporating neuroimaging techniques and stresses the vulnerability of this patient population who might be aware but otherwise unable to communicate such facts. He synonymously noted that the simple presence of consciousness with sentience out of concern for maleficent actions. Thus, he concluded with positing evaluative recommendations of beneficence in the face of ambiguous diagnostic data to best respect the patient’s possible level of sentience.Joseph J. Fins, Laura Specker Sullivan and L. Syd M JohnsonDr. Laura Specker Sullivan started her presentation describing the complexity of consciousness and how it includes philosophical topics such as self-awareness, alertness, and perceptiveness. When examining biological beings for consciousness, she continued, the prominent dimensions of assessment include wakefulness and awareness. Wakefulness is synonymous with arousal where awareness is understood when someone has an object of their perception. This is best seen in vegetative patient’s where they have levels of wakefulness but are absent awareness. She stressed that contemporary concern about patients being in a minimally conscious state stems from the fact that culturally we place ethical importance on awareness, however minimal that awareness may be. Assessing degrees of awareness, as discussed in Dr. Fin’s lecture, has only become more complicated and nuanced with the use of neuroimaging techniques.Dr. Specker Sullivan further examined the philosophy of mind contrasting sentience, the ability to experience good or bad states, to sapience, which is a human’s rational mind. She also contrasted transitive consciousness, or awareness of an object, to intransitive consciousness, which is understood as pure experience, much like meditation. She, then, questioned the implicit ethical value our culture gives to consciousness that is grounded in its internal value and sometimes its instrumental value for pleasurable experiences. Each of these justifications have their own ethical recommendations. She tied these topics together by describing that when patients simply retain a level of wakefulness there may be an ethical imperative to protect them due to the intrinsic value of consciousnesses. She describes that diagnostically confirming this is still a clinical challenge with it hard to prove that some level of transitive conscious isn’t present. Thus, given this varying clinical uncertainty, she recommended the focus should be on examining if patients are sentient beyond the complicated question of their state of consciousness, which is in line with classical bioethical notions of beneficence.Dr. Syd Johnson began her presentation discussing the historical pace of disorders of consciousness moving from the 1970s to a more staggering pace in the past two decades with the identification of Unresponsive Wakefulness Syndrome and cognitive motor dissociation. She questioned if current clinically diagnostic categories are now ethically adequate to encompass the vast variety of conscious states and their moral nuances accumulating in the medical community. She stated that we are currently in an age of uncertainty regarding medical understandings of consciousness due to the increased implementation of diagnostic criteria with neuroimaging. She contends that the ethical notions have not kept pace with this scientific growth and cites historical uses of ethical risks in the philosophy of science being used to increase the level of skepticism towards a notion of truth (due to the levels of deleterious consequences that could result). This leaded her to advocate that with epistemic uncertainty, scholars ought to be more careful in their bioethical or neuroethical risk taking since consciousness matters in respect to many factors, including personhood. She gave an example of such risk with the notion of the vegetative state being culturally sensitive due to its social understanding as “more dead than dead.” Thus, she recommended, as the diagnoses of the disorders of consciousness continue to progress, that they include more accurate assessments of risks in their nomenclature.Summary written by Ian StevensReferences:”Guideline Detail | American Academy of Neurology.”Schiff, “Cognitive Motor Dissociation Following Severe Brain Injuries.”PhotosMany thanks to Gillian Hue for capturing key moments from the annual meeting. Other photos from the meeting are available upon request for personal or professional use. Contact staff by email (administrator@neuroethicssociety.org) with your requests. Please be sure to credit Gillian Hue when sharing photos online.Nita Farahany and Matthew Baum after his lecture titled ‘The Neuroethics of Biomarkers’Emily Largent speaking at the Preclinical Interventions in Psychiatric and Neurological Disorders sessionChristopher Pham presenting his poster to Deena KopytoShelly Benjaminy and Ian Stevens at the poster presentation sessionAttendees participating in the Global Neuroethics roundtable discussionMichael Patterson presenting essay contest winners Khayla Black, Sunidhi Ramesh and Prithvi Nathan, with Hank GreelyPublic program speakers Nicole Martinez-Martin, Ilina Singh and David C Mohr

Meeting Program

Mapping Neuroethics: An Expanded Vision

• Many thanks to our meeting sponsors and stipend contributors for their generous support
• Readings listed below include speaker interviews and articles identified by speakers

Sponsors

MEETING VENUE

Radisson Blu Aqua Hotel
221 North Columbus Drive
Chicago, IL USA 60601

THURSDAY, OCTOBER 17, 2019

9:00–9:30 AM

Registration / Networking

• Check in at the registration desk
• Install posters in the Baltic–Bering Room
• Light breakfast 

9:30 AM

Welcome

• Hank Greely, INS President
• Ilina Singh and Arleen Salles, INS Program Committee co-chairs

9:45–10:45 AM / OPENING LECTURE

Matthew L. Baum

Harvard Medical School

• Introduction by Ilina Singh, University of Oxford (UK)
• Lecture by Matt Baum on ‘The Neuroethics of Biomarkers‘
• Discussion and Q&A with Nita Farahany, Duke Law School (USA)

Readings

• Neurotechnology produces a better diagnosis, but what are the ethical implications for people with mental illness? Interview with Matt Baum
• The neuroethics of biomarkers: what the development of bioprediction means for moral responsibility, justice, and the nature of mental disorder. Book
• Can Facebook’s Machine-Learning Algorithms Accurately Predict Suicide? Article
• Predicting schizophrenia: Calculator can predict psychosis risk. Article
• Progress in predicting suicide. Article

10:45 AM–12:15 PM / PACIFIC BALLROOM

Ethics and the Imprisoned Brain

As researchers begin to investigate techniques for altering inmates’ brains to rid prisons of what Anthony Burgess called ‘the ultra-violence,’ the ongoing neuroethics discourse about biological approaches to criminal justice takes on renewed urgency. Speakers will address the promise and peril of neuro-interventions for incarcerated persons, whether in research and development or implementation and oversight.

• Olivia Choy, Nanyang Technological University / University of Pennsylvania (Singapore/United States)
• Farah Focquaert, Ghent University (Belgium)
• Andrés Molero-Chamizo, University of Huelva (Spain)
• Jan Christoph Bublitz, University of Hamburg (Germany)
• Moderated by Roland Nadler, University of British Columbia (Canada)

Readings

• Neuroscience May Help Curb Prison Violence – But Should It? Interview with Roland Nadler
• Benign Biological Interventions to Reduce Offending. Article
• Bilateral prefrontal cortex anodal tDCS effects on self-reported aggressiveness in imprisoned violent offenders. Article
• In Spain, prisoners’ brains are being electrically stimulated in the name of science. Article

12:15–1:30 PM

Boxed Lunches / Poster Presentations

• Poster presentations and judging in the Baltic–Bering Room

1:30–2:45 PM / Concurrent Sessions

Pacific Ballroom

Preclinical Interventions in Psychiatric and Neurological Disorders

As we get better at using genetic, metabolic or behavioral biomarkers to predict future susceptibility for neurological and psychiatric syndromes, the problem of medical management of people in such preclinical states becomes more trenchant. Testing preventive drugs, informing patients or parents of risks, managing false positives, and treating patients with little discernible illness raise significant ethical questions that we will discuss with a panel of experts.

Speakers

• Caesar Atuire, University of Ghana (Ghana)
• Emily Largent, University of Pennsylvania (USA)
• Gabriela Pavarini, University of Oxford (UK)
• Moderated by Anna Wexler, University of Pennsylvania (USA)

Readings

• BeGOOD: Becoming Good: Early Intervention and Moral Development in Child Psychiatry. Website
• Comprehension of an Elevated Amyloid Positron Emission Tomography Biomarker Result by Cognitively Normal Older Adults. Article
• Attitudes Toward Physician-Assisted Death From Individuals Who Learn They Have an Alzheimer Disease Biomarker. Article
• Pragmatic Neuroethics: Lived Experiences as a Source of Moral Knowledge. Article

Caribbean-Caspian Room  /  WELLCOME SYMPOSIUM

Disorders of Consciousness: Concepts, Culture and Prognosis

This session will explore the importance of concepts when addressing disorders of consciousness. Speakers will discuss the cultural dimensions and ethical implications of selecting concepts, how concepts can impact practice protocol and medical decision-making, and the potential consequences of categorizing patients.

• Joseph J. Fins, Weill Cornell Medical College (USA)
• L. Syd M Johnson, Michigan Technological University (USA)
• Laura Specker Sullivan, College of Charleston (USA)
• Moderated by Hannah Maslen, University of Oxford (UK)

Readings

• Ethical, palliative, and policy considerations in disorders of consciousness. Article
• Pure Experience and Disorders of Consciousness. Article
• Prognostication of chronic disorders of consciousness using brain functional networks and clinical characteristics. Article
• Inference and Inductive Risk in Disorders of Consciousness. Article

BREAK / 2:45–3:00 PM

3:00–4:00 PM / Concurrent Sessions

Abstract Presentations

Two concurrent sessions of authors who submitted an abstract will be selected to give a talk about their neuroethics research and area of study. Each talk will be about 10-15 minutes in length and a question and answer period will follow the full set of talks.

Pacific Ballroom

• Ashwini Nagappan, University of Pennsylvania (USA)
• Demetrio Sierra-Mercado, Baylor College of Medicine / University of Puerto Rico (USA)
• Andreas Wolkenstein, LMU Munich (Germany)
• Introductions by Adrian Carter, Monash University (Australia)

Caribbean-Caspian Room

• Timothy Brown, University of Washington (USA)
• Jayashree Dasgupta, Sangath (India)
• Armani Porter, Duke University (USA)
• Introductions by Roland Nadler, University of British Columbia (Canada)

TRAVEL TIME / 4:00–4:30 PM

4:30–7:00 PM / PUBLIC PROGRAM

Should we trust technology to provide mental health care?

The INS and Northwestern Medical School have organized a public event to discuss the question: Should we trust technology to provide mental health care? Presenters will describe how digital technologies are being used to support mental health and the importance of the human medical professional in some mental health interventions.

• David C Mohr, Northwestern University (USA)
• Ilina Singh, University of Oxford (UK)
• Nicole Martinez-Martin, Stanford University (USA)
• Moderated by Kelly Michelson, Northwestern University (USA)

Location

Daniel Hale Williams Auditorium
McGaw Pavilion, Northwestern University
240 East Huron Street
Chicago, IL 60611

Agenda

• 4:30pm – Doors open for attendees
• 4:30–5:15pm – Meet and greet reception 
• 5:15–6:30pm – Speaker Presentations 
• 6:30–7:00pm – Group discussion and audience questions
• 7:00pm – Event concludes

7:30 PM

Affinity Groups Dinner

Venue to be announced

FRIDAY, OCTOBER 18, 2019

9:00–9:25 AM

Networking

• Light breakfast

9:25 AM

Welcome

• Ilina Singh and Arleen Salles, INS Program Committee co-chairs

9:30 AM–12:00 PM

Dilemmas in Global Neuroethics

The existence of several national-level brain research initiatives and the priority given to investment in neuroscientific research make evident the importance of unveiling and reflecting on the values driving the research and of addressing the ethical, social, and philosophical issues raised by it. One goal of the session is to have panelists representing the different brain initiatives briefly address a few neuroethics issues, identifying and highlighting important cultural aspects.

To what extent can human attributes be modeled?

• Moderated by Tom Buller, Illinois State University (USA)
• Khara Ramos, National Institutes of Health (USA)
• Norihiro Sadato, National Institute for Physiological Sciences (Japan)

Beyond disease, what are aspirational applications?

• Moderated by Marcello Ienca, ETH Zurich (Switzerland)
• Adrian Carter, Monash University (Australia)
• Arleen Salles, Uppsala University (Sweden)

Engaging neuroethics: what are the questions?

• Moderated by Karen Rommelfanger, Emory University (USA)
• Judy Illes, University of British Columbia (Canada)
• Sung-Jin Jeong, Korea Brain Research Institute (South Korea)

Discussion

• World cafe discussion led by Paul Root Wolpe, Emory University (USA)

Readings

• Neuroethics Questions to Guide Ethical Research in the International Brain Initiatives. Article
• A Neuroethics Backbone for the Evolving Canadian Brain Research Strategy. Article
• A Neuroethics Framework for the Australian Brain Initiative. Article
• The Human Brain Project: Responsible Brain Research for the Benefit of Society. Article
• Neuroethical Issues of the Brain/MINDS Project of Japan. Article
• Responsibility and Sustainability in Brain Science, Technology, and Neuroethics in China — a Culture-Oriented Perspective. Article
• The NIH BRAIN Initiative: Integrating Neuroethics and Neuroscience. Article
• Korea Brain Initiative: Emerging Issues and Institutionalization of Neuroethics. Article

12:00–1:00 PM / BALTIC ROOM

Poster Presentations

• Poster presentations and judging in the Baltic–Bering Room
• Attendees may vote for their favorite poster

1:00–2:30 PM

Boxed Lunch / Business Meeting

• Presentation of the Steven E. Hyman Award for Distinguished Service to the Field of Neuroethics
• Announcements from INS President Hank Greely
• Updates from INS committee chairs

2:30–4:00 PM

Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?

Many laws define psychosurgery to include deep brain stimulation (DBS) for psychiatric indications, a field under intensive exploration and expansion. This session will consider the history, present and future, of the regulation of invasive psychiatric neuromodulation such as DBS, with particular attention to the questions of whether there is a need for specific law, and what its optimal contents should be.

Speakers

• Laura Cabrera, Michigan State University (USA)
• Eran Klein, Oregon Health & Science University / University of Washington (USA)
• Lauren Sankary, Cleveland Clinic (USA)
• Moderated by Jennifer Chandler, University of Ottawa (Canada)

Readings

• Working at the Intersection of Brain Science, Law and Ethics Interview with Jennifer Chandler
• Consensus Guidelines for Stereotactic Neurosurgery for Psychiatric Disorders. Article
• Report and Recommendations Psychosurgery. Washington Report
• Evolution in the Treatment of Psychiatric Disorders: From Psychosurgery to Psychopharmacology to Neuromodulation. Article
• Should DBS for Psychiatric Disorders be Considered a Form of Psychosurgery? Ethical and Legal Considerations. Article
• Psychosurgery: avoiding an ethical redux while advancing a therapeutic future. Article
• Scientific and ethical issues related to deep brain stimulation for disorders of mood, behavior, and thought. Article
• Ethical guidance for the use of deep brain stimulation in psychiatric trials and emerging uses: Review and reflections. Chapter

BREAK / 4:00–4:30 PM

4:30–5:30 PM / FRED KAVLI DISTINGUISHED NEUROETHICS LECTURE

Martha J. Farah

Center for Neuroscience & Society
University of Pennsylvania

• Introduction by Hank Greely, INS President
• Lecture on ‘Socioeconomic status and brain development: from science to policy’

Readings

• The brain and socioeconomic status: how do we apply it to real-world policy? Interview
• State of the Art Review: Poverty and the Developing Brain. Article
• The Poverty of the Neuroscience of Poverty: Policy Payoff or False Promise? Article
• Socioeconomic status and the brain: prospects for neuroscience-informed policy. Article, PDF

5:30–6:30 PM

Awards Reception

• Presentation of poster and essay awards by Hank Greely
• Recognition of Neuroethics Essay Contest winners by Dr. Michael Patterson and Marcello Ienca, INS Student/Postdoc Committee chair
• Beverages and hors d’oeuvres served

Registration

Register to attend this meeting.

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Sponsors 

Stipend Contributors

• James and Elisabeth Ewing
• Dr. Michael Patterson
• Anonymous

Interview With Program Committee Co-Chairs

The INS annual meeting brings together people from around the world with shared goals in neuroethics

Ilina Singh and Arleen Salles are co-chairs of the Program Committee for the 2019 INS Annual Meeting. Their task is to put together a dynamic program of panel discussions, lectures, and opportunities for networking. Some ideas may challenge conventional thinking on neuroethics issues. Ilina, Arleen, and their committee members have put a major emphasis on inclusion, diversity, and culture to create an INS meeting that truly represents the ‘international’ nature of our Society.

Ilina Singh

Arleen Salles

Ilina Singh is professor of neuroscience and society in the Department of Psychiatry at the University of Oxford, UK, is co-director of the Wellcome Centre for Ethics and Humanities, and is a distinguished research fellow with the Oxford Uehiro Centre for Practical Ethics.

Arleen Salles is a senior researcher in the Centre for Research Ethics & Bioethics at Uppsala University in Sweden. She is the director of the Neuroethics Program at the Centro de Investigaciones Filosóficas in Buenos Aires, Argentina, and a task leader in the Ethics and Society subproject of the EU Human Brain Project.

What is your field of research?

Ilina Singh – I am investigating the social and ethical implications of novel neurotechnologies. I am particularly interested in neurotechnologies that directly affect children and families, and those that challenge traditional conceptions of human agency, identity and relationship.

Arleen Salles – I am working on the issue of how to understand neuroethics, and in particular the development of a culturally aware neuroethics, on one hand, and on the other, on conceptual issues in human identity and the self. 

What got you interested in neuroethics?

Singh – Some years ago I was working on the ethics of giving Ritalin to children diagnosed with ADHD. That led to discussions about ‘smart drugs,’ which were being used by university students allegedly to enhance their cognitive capabilities. That was my introduction to neuroethics. Since then, we’ve discovered that smart drugs don’t make you smarter, but other neurotechnologies, such as brain implants and brain–computer interfaces, could enhance cognitive performance in particular domains.

Salles – Trained in philosophy, I was always interested in ethical theory, in particular moral reasoning, the emotions, and what their proper role should be in the discussion of applied issues. This led to further reading and research not only in philosophy but also on the potential contribution of neuroscience in enriching our understanding of morality. Initially this is what got me interested in this discipline.

Why are you involved with the International Neuroethics Society?

Singh – The INS provides a wonderful community of people with an increasingly global interest in neuroethics. We have bioethics programs [at universities] but few specific to neuroethics. It’s good to have a growing community for those with neuroethics interests.

Salles – The INS makes it possible for members to be in contact with people with shared interests. Importantly, it is trying to give a voice to neuroethicists from countries who are typically under-represented, which I am committed to.

Describe the challenge for you as co-chairs of the Program Committee for the INS annual meeting.

Singh – I was delighted to be able to partner with Arleen because both of us represent non-U.S. perspectives. We’ve been trying to internationalize neuroethics for some years. I’m also keen to get the neuroethics community to focus more on young people and mental health — the ethics is still underplayed. We have been able to bring that into the annual meeting by focusing on early intervention and predictive technologies.

Salles – Ilina and I were involved in all aspects of the meeting. We agreed in what we wanted to emphasize in the program and we discussed each panel and the extent to which it was compatible with our vision of the meeting. We wanted inclusiveness and this is what I think the program achieved. We also have a fantastic team in the Program Committee who have been very active in the planning. Co-chairing with Ilina and joining efforts with the Program Committee has been a very productive and enriching experience.

What do you envision with the theme ‘Mapping Neuroethics: An Expanded Vision’?

Singh – With ‘Mapping Neuroethics’ we wanted to bring more international substance and content into the meeting. For example, how does an African bioethics perspective conceive of neuroethics challenges? Getting a better handle on international perspectives might lead us to reframe some challenges, or even to rethink neuroethics strategic priorities. Should we think differently about autonomy concerns, or about the moral status of animals? Dialogue among diverse perspectives should be mutually disruptive and stimulating, and will hopefully create fresh thinking in our field.

Salles – As stated before, one of my main concerns was including people from different cultures who have not so far been part of the neuroethics discussion, or who have not been heard. This is our ‘expanded vision.’ However, culturally-aware neuroethics is not a one-way street. It’s about dialogue and it’s important to listen and to solve problems together.

What parts of the annual meeting are you excited about?

Singh – All of it! But particularly we have tried to build up the time we give to early career researchers. They are the future of neuroethics and we need to hear more from them. The program gives opportunities for early career researchers to give big, long talks, to speak on panels, and — for those who are selected — to talk about their posters.

Salles – I want to see how the cultural aspect plays out, interacting with people with other insights. We have also put a lot of emphasis on giving a voice to early career researchers. I am very excited about their contribution to the different panels.

What are the dilemmas in global ethics?

Salles – I am one of the speakers in the session on ‘Solving Dilemmas in Global Neuroethics.’ We have invited representatives from the different brain initiatives — active or being formed — in South Korea, Japan, China, Australia, Canada, the U.S., and Europe who will be discussing different hot topics and how they address them in their respective brain initiative. Collectively, we want to promote interaction on diverse ethical approaches to some of the important issues in global neuroethics.

Why should people attend the INS annual meeting?

Singh – This is your community. The annual meeting is your chance to meet people working on similar questions and common goals. It is interdisciplinary, increasingly attracting people from law, engineering and psychology. And it’s fun — we are still a small community and we have a good time together!

Salles – You will meet people who have reflected on a number of issues. It seems to me that one good reason is that as human beings — academics as well as the public — we ought to be interested in where neuroscience is taking us, and its social, legal, and ethical implications so that we can figure out what to do next.

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Mapping Neuroethics: An Expanded Vision

The 2019 Annual Meeting of the International Neuroethics Society (INS) will gather a diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science. Attendees will participate in intellectually stimulating and dynamic sessions that will explore neuroethics in a global context.

Discounted registration rates are available until September 20.

Meeting Program

Interview With Martha Farah

The brain and socioeconomic status: how do we apply it to real-world policy? 

Martha J. Farah is the Walter H. Annenberg Professor of Natural Sciences at the Center for Neuroscience & Society, University of Pennsylvania. She is a cognitive neuroscientist who works on problems at the interface of neuroscience and society. She has degrees in metallurgy and philosophy from the Massachusetts Institute of Technology and a doctorate in psychology from Harvard University.  Farah will give the Fred Kavli Distinguished Neuroethics Lecture at the 2019 INS Annual Meeting.

What is your field of research?

My general field of research is cognitive neuroscience — that is, the relation between the mind and the brain. If that makes me sound like a frustrated philosopher, it’s probably because I am! I am fascinated by philosophical problems like what a mind is, how we develop into such different individuals, how we come to believe things, and what makes a person the same person over time despite the many changes we all undergo. But I am also an experimentalist at heart, so I decided to work on the science of these topics.

My recent research has focused on socioeconomic status (SES) and brain development. SES is a ubiquitous feature of human societies. Everywhere there are people who are better off and people who are worse off in terms of resources, power, prestige, etc. These differences matter; SES is linked to the way we think and solve problems and to our well-being and mental health. But until recently, there was not much of an effort made to understand how and why SES is linked to the brain. Which is weird, because thinking and mental health are functions of the brain!

What will your lecture cover?

I will be talking about the relevance of SES neuroscience to policy. It seems natural to expect science to inform policy — after all, once we understand the pathways through which socioeconomic disadvantage is linked to diminished capabilities and diminished well-being, we should have better targets for interventions on societies, communities and individuals. Then again, the science itself is very young and incomplete. So we have to ask: what do we know so far, and is any of it yet applicable to real-world policy? That’s what I’ll be covering, in a nutshell.

What are the key neuroethical issues in translating science to policy [in context with socioeconomic status and brain development]?

There are many ethical issues involved in translating this work into policy. One obvious one is that the premature application of scientific ideas that are not firmly grounded in evidence can be a waste of time and resources, or worse, harmful to the people we want to help.

In addition, there are subtler issues to consider, about where to place blame for the ills of poverty. If our explanations of lowered IQs and raised rates of depression involve the brains of affected individuals, are we in some sense blaming these individuals for their own suffering? Do neuroscience explanations divert attention from societal injustices that operate upstream of individual brains?

What got you interested in neuroethics, and what is its significance in the ‘real world’?

I think I have always been interested in neuroethics, even before I knew the word! Earlier in my career, my only dissatisfaction with my chosen field of cognitive neuroscience was that it seemed a bit ‘ivory tower.’ It bothered me that the beautiful science taking place in the late 20th century on mind and brain seemed so unable to contribute to solving social problems. Happily, as cognitive neuroscience has advanced, it has become applicable to all kinds of problems, from the law to education to psychiatry. And once the field has the capability to impact human life, ethical issues arise.

What was your role in the early days of the INS?

I was part of small group of early neuroethics enthusiasts who looked around and saw the emerging role of neuroscience in society, and I wanted to convene fellow scientists and scholars to think seriously about the ethical issues. The plan succeeded wonderfully! The INS has spread awareness of ethical issues in neuroscience and catalyzed great discussion and collaboration around the world!

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Mapping Neuroethics: An Expanded Vision

The 2019 Annual Meeting of the International Neuroethics Society (INS) will gather a diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science. Attendees will participate in intellectually stimulating and dynamic sessions that will explore neuroethics in a global context.

Discounted registration rates are available until September 20.

Meeting Program

Interview With Matthew Baum

Neurotechnology produces a better diagnosis, but what are the ethical implications for people with mental illness?

Matthew Baum is an MD-PhD student at Harvard Medical School. He graduated from the Molecular, Cellular and Developmental Biology department at Yale University, then studied neuroscience at Trinity College Dublin in Ireland and completed a D.Phil. in neuroethics at the University of Oxford in the U.K. He completed the PhD Program in Neuroscience at Harvard University where he investigated neural–immune interactions in the development of psychiatric disease and is now finishing his medical training with a plan to specialize in psychiatry. Baum will be giving the opening lecture at the 2019 INS Annual Meeting on Thursday morning, October 17.

What is your field of research?

I am studying mental health and the medicine and science associated with it. I am finishing my clinical training in medical school where I am focused on psychiatry. I did my PhD investigating the role of immune molecules in schizophrenia, and I am hoping to unite this with a clinical focus around the immune system and mental health.

It’s a new area and we are learning that molecules in the immune system sometimes get dysregulated and affect the brain, which in turn can influence mental illness. For example, we are learning that a tumor in a completely different part of the body can sometimes secrete antibodies that affect brain function in a way that produces psychosis and looks a lot like new-onset schizophrenia. The field has thought for a long time that the biology of schizophrenia and other psychiatric illnesses is likely to be highly diverse, so now we can ask how often does disruption of the immune system lead to symptoms we define as a particular kind of psychiatric illness? The neuroethics I am fascinated by is in how neurotechnology and biomarkers converge with the clinical sphere of psychiatry and neurology.

What will your lecture be about?

I will be talking about the neuroethics of biomarkers, that is, how variations in genes, molecules in the blood, and anything you can measure can predict things like cognitive decline and psychotic episodes. I will also discuss what obligations there are, and on whom, for this predictive technology in medicine and law.

What are the main neuroethical issues in biomarkers for brain disorders?

I’ll give you an example that would apply in law. When a person has a seizure that could harm someone else — say through a road accident — the person who has the seizure can be excused because they didn’t know it was going to happen. But if he or she knows they are at risk of a seizure yet chooses to drive at that time and has a seizure, the responsibility falls on that driver. So we have to work out how our responsibility is affected by big data techniques that can, with a handful of biomarkers, in one fell swoop notify us of not just one, but hundreds of different biological risks; risks such as a heart attack, stroke, or even lack of attention. And if we choose not to gain that information, is our ignorance culpable or excusable?

What got you interested in neuroethics?

When I was training in basic neuroscience and then later at medical school, I saw how many philosophical and ethical complications this new knowledge of the brain could produce. Just because people are at high risk of a psychotic episode, do they actually have a mental illness? How do we decide whether something should be considered a mental illness? I wanted to approach these sort of questions with the same sort of rigor as in the science that provoked them.

As a previous student representative of the INS, why is it so important for young scholars to be involved with neuroethics?

Younger people are on the front line in neuroscience, medicine, philosophy, and the law. By virtue of that experience, young people can bring real value to the field of neuroethics. Also, most scholars in neuroethics have transitioned into it laterally from one of the associated disciplines like law or science. But for young people, in addition to that traditional path, there is potential for their real insight growing into the field (as a primary interdisciplinary pursuit), rather than transitioning laterally into it.

What are you most excited about at the annual meeting?

Most exciting for me is the informal conversations between lectures and in front of posters — the bubbling up of new ideas in an environment of shared interest. At our individual institutions, one may go a long time before finding someone with similar interests in neuroethics.

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Mapping Neuroethics: An Expanded Vision

The 2019 Annual Meeting of the International Neuroethics Society (INS) will gather a diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science. Attendees will participate in intellectually stimulating and dynamic sessions that will explore neuroethics in a global context.

Discounted registration rates are available until September 20.

Meeting Program

Interview With Roland Nadler

Neuroscience May Help Curb Prison Violence – But Should It?

Roland Nadler, JD, is starting a doctorate program in law at the University of British Columbia. He was formerly Visiting Professor at the University of Ottawa in the Center for Health, Law, Policy and Ethics. He will moderate a panel discussion on ‘Ethics and the Imprisoned Brain’ at the 2019 INS Annual Meeting.

Describe your background and your field of research

I’m a neuroethicist and a legal scholar. I became interested in neuroscience and law while I was at Neuroethics Canada in Vancouver, then I went to Stanford Law School, and now I’m about to embark on a PhD back at UBC. My particular focus is the way in which the growing understanding of brain science and neurotechnology will impact the legal system in terms of both evidence and doctrine. Neuroscience will help change how moral and legal concepts are understood by lawyers and the public.

What got you interested in neuroethics?

Part of the influence was the philosophy I studied as an undergraduate in context with cognitive neuroscience. It made me think carefully about concepts of brain and mind, and how that could be better applied to society. Law school increased my awareness of neuroscience’s impact on how individual cases are litigated.

Why are you involved with the INS?

The INS has accompanied me every step of the way through my academic career. Steve Hyman [former President of the INS] encouraged me to go to the 2008 annual meeting and I was immediately hooked. Since then, the INS has been both important professional service and enjoyable—it’s my favorite event of the year!

What will the session cover that you are moderating?

The theme of ‘Ethics and the imprisoned brain’ came to my attention in an article on a study in Spain where the investigators had worked on possibility of using brain stimulation to reduce aggressive behavior in prison populations. The topic dovetails with projects I have been working on at the University of Ottawa. Being in prison is horrible enough even without violence, yet the power in the hands of medicine or the state to make people more docile may sound dystopian. There are also pressing but not insurmountable research ethics challenges on how to run studies in prisons.

What are some of the existing and emerging neuro-interventions being used in prisons to deal with violent crime?

The technology of most interest now is transcranial direct current stimulation (tDCS). It’s not easy to talk about running electricity through brains – tDCS only uses a mild current – but that doesn’t mean it is risk free. When we are evaluating it shouldn’t be freighted with associated legitimate techniques like electro-convulsive therapy or discredited interventions like lobotomy. The de facto method of “treating” aggression is with anti-psychotic drugs, but that’s not ideal solution.In the future? Without speculating too many decades away, one could use non-invasive neuro-feedback to help prisoners retrain their own brains. There are always science fiction ideas around more invasive, even surgical methods, which should put neuroethics high on the agenda. Could there be Clockwork Orange re-programming of the criminal brain? Few if any people want to do that but the ideas arise from humane impulses, so we need to design a process to prevent potentially dangerous power being misapplied.

What parts of the Annual Meeting are you excited about?

For me, one of the greatest excitements is seeing the posters that early career scholars are presenting. People coming to the INS annual meeting for the first time, maybe they are even representing their country for the first time.

Why should people attend the INS Annual Meeting?

So many reasons: firstly because it’s the best available opportunity to talk about the best work being done in this interdisciplinary field. You make connections with the people who are at the forefront of research, and with those coming up with new ideas. I see much room for neuroethics to grow, but one of the virtues of it being fairly small now is that you can speak to leaders in the field.

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Mapping Neuroethics: An Expanded Vision

The 2019 Annual Meeting of the International Neuroethics Society (INS) will gather a diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science. Attendees will participate in intellectually stimulating and dynamic sessions that will explore neuroethics in a global context.

Discounted registration rates are available until September 20.

Meeting Program

Interview With Jennifer Chandler

Working at the Intersection of Brain Science, Law and Ethics

Jennifer Chandler is internationally recognized for her research and writing in the law and ethics of brain sciences. She holds the Bertram Loeb Research Chair at the University of Ottawa in Canada and has launched Neuroethics-Panamericana, a group of clinicians, ethicists, and social scientists who are collaborating on the regulation of neuromodulation. She is an elected member of the INS Board of Directors. Chandler will be moderating a panel discussion on ‘Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?’ at the 2019 INS Annual Meeting on Friday afternoon, October 18.

Describe your background and your field of research

I started out in biology, and intended to move into medicine or neuroscience. Part of the way through, I took an elective course in international law and became fascinated by social problems. Before I knew it, I was in law school, and then practicing law. However, my interest in science and the brain remained and now I specialize in the intersection of the brain sciences, law, and ethics, looking at concrete problems of how to regulate particular neuro-interventions to the more abstract questions of how neurobiological concepts affect law and legal procedures. I teach mental health law and neuroethics in law school, among other topics. My research is broader, however, and explores the impact of brain sciences on law, from human rights law, family law, the rules of evidence and tort law to criminal and correctional law.

What got you interested in neuroethics?

I’ve always been interested in the brain and mind. As a teenager I was very interested in consciousness and creativity, and I still am. I count myself as very lucky to have landed in this field, as it allows me to investigate how we understand ourselves, how we think, perceive, and behave, and how we should address the social challenges and frictions of living in technologically advanced but highly unequal societies. The scope of imagination and the pace of discovery in neuroscience and technology also means there is something new to think about every day over breakfast.

Why are you involved with the INS?

The INS brings together a wonderful interdisciplinary and international group of thinkers. I have found many true friends at the INS and I look forward to seeing them at meetings. It’s an important group for the future of the field. I’m pleased that the INS is committed to internationalizing, so that we can mutually benefit from looking at neuro-ethical questions through different cultural lenses.

Describe the session cover that you are moderating on ‘Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?’

Psychiatric neuromodulation (including psychiatric neurosurgery) is a rapidly evolving field, in terms of the technologies employed, but also the target conditions and symptoms. There is a lot of excitement and concern within the field to ensure that its development is not be imperilled by questionable practices. There are quite a few laws around the world already that explicitly regulate ‘psychosurgery,’ reflecting concerns with patient vulnerability and the need for oversight and data collection. Now is the time to pull people together and ask: how we can come to a common position? How do we share data? Are existing laws inappropriate? Do we need an international context for surgeons and researchers who work in other countries, and for patients who migrate?

Can the law and regulation keep up with the speed of the development of new neurotechnology?

Using psychiatric neurosurgery as an example, most of the existing laws were written when the technology we have now did not exist. So the laws may refer to procedures that sound like deep brain stimulation but they are often actually out of step with newer forms and might, therefore, raise new issues in regulation. Maybe the current laws are adequate, but questions need to be asked. For example, who owns the algorithm that determines the stimulation required to affect someone’s personality and thinking?

What parts of the annual meeting are you excited about?

First, I’m very excited about the program itself. There are excellent subjects and speakers. Second, as a member of the Program Committee I’ve been able to review some of the abstracts that have been submitted and there are some really great topics. We are going to have a wonderful set of posters to read, and I look forward to speaking with the contributors. Finally, I value the conversations with colleagues over lunch and coffee.

Why should people attend the INS annual meeting?

Because of the richness of the content of the sessions and the discussions they inspire, and also so that people can join a vibrant and growing community helping us develop the field.

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Mapping Neuroethics: An Expanded Vision

The 2019 Annual Meeting of the International Neuroethics Society (INS) will gather a diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science. Attendees will participate in intellectually stimulating and dynamic sessions that will explore neuroethics in a global context.

Discounted registration rates are available until September 20.

Meeting Program