Ethics must be considered early and often as the field of modern neuroscience forges ahead, in order to avoid repeating a dark period in history when lobotomies were common, experts said Wednesday.
President Barack Obama asked for the recommendations of the Presidential Commission for the Study of Bioethical Issues, as part of his $100 million Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative announced on 2013.
The first of two reports by the commission was released Wednesday, containing four recommendations for how ethics should figure prominently in future research.
It is "absolutely critical... to integrate ethics from the get-go into neuroscience research," and not "for the first time after something has gone wrong," said Amy Gutmann, Bioethics Commission Chair.
As recently as the 1940s and 50s, thousands of lobotomies were performed in the United States, as enthusiasm swept the media and the medical field and the dangers were largely ignored.
The surgery involved poking holes in the skull and brain in an effort to alleviate symptoms of mental illness, though the procedure often left patients incapacitated. Lobotomy was eventually discredited in the 1950s.
"In the case of the history of lobotomy, there was great hype and great damage done, so it is very important that we learn from this history," Gutmann told reporters ahead of the report's release.
- One billion affected -
Contemporary neuroscience is a relatively new field that includes research on Alzheimer's, traumatic brain injury, depression, Parkinson's disease and more.
All told, neurological conditions affect more than one billion people globally, the commission said in its report.
Science is moving ahead on improvements in brain imaging, dementia research, deep brain stimulation to alleviate symptoms of Parkinson's disease, as well as electrical implants that could boost memory and brain function.
But each of these areas raises ethical concerns, including at what point people with dementia can truly give informed consent to researchers, and whether cognitive enhancements could be unfairly distributed in society, Gutmann said.
Advances in brain imaging could also lead to questions about mental privacy, and the use of deep brain stimulation should be compared to other interventions "to separate hope from hype," she said.
Commission member and neuroimmunologist Stephen Hauser said the field is poised to accelerate rapidly in the coming years, and that means all neuroscientists must be aware of the ethical questions involved.
"Not all neuroscientists are equally attuned," Hauser said.
"We are truly on the threshold of making practical discoveries and advances that could provide enormous benefits but also need to be assessed in terms of their appropriate use by all stakeholders."
The commission urged institutions and individuals engaged in neuroscience research, as well as government agencies and other funders to:
- Integrate ethics early and explicitly throughout research.
- Evaluate existing and innovative approaches to ethics integration.
- Integrate ethics and science through education at all levels.
- Explicitly include ethical perspectives on advisory and review bodies.
The next phase of the commission's work is to examine more deeply the ethical and societal implications of neuroscience research.