July 6, 2012
By S. Matthew Liao
CHANGING SELVES: Direct Brain Interventions to “Treat” Disfavored Human Behaviors **
Stanford Law School, September 24-26, 2012.
As neuroscience teaches us more about the causes of human behaviors, direct brain interventions to change those behaviors by targeting those causes might eventually be developed. When behaviors are caused by “brain diseases”, effective and safe treatments that intervene directly in the brain will probably be readily accepted and even embraced. But what about direct brain interventions that treat the brain-based causes of socially disfavored behaviors that are not generally viewed as diseases?
For instance, if a safe and effective direct brain intervention were developed that diminished aggression – e.g. a drug, magnetic or electric brain stimulation, or brain surgery – should it be permissible to offer and maybe even to coerce or compel convicted violent criminals to undergo such treatments? Should it be permissible to offer such treatments as an alternative to prison or detention, or as a condition of fitness for release back into society? Should it be permissible to offer/coerce/compel children with psychopathic traits – e.g. extreme cruelty to animals and seriously antisocial behaviour – to undergo similar treatments should such ever be developed?
Should people be permitted, and perhaps sometimes even expected (e.g. by their employers, customers or by society at large), to use cognitive enhancement medications? For instance, would it be reasonable to expect surgeons performing difficult and lengthy operations, or those working night shift or performing surgery for extended hours, to take drugs like Modafinil or Ritalin to improve their performance? Might it be reckless for them to refuse to do this if the benefits (in terms of improved performance or diminished risk of harm) were sufficiently great and the costs (both financial and in terms of unwanted side effects) were sufficiently low?
Finally, should people be allowed to alter their own brains in whichever way they desire — i.e. to make their very selves the way they want to be? For instance, if a safe and effective “treatment” for shyness, homosexuality or transsexualism were developed, under what conditions should people be permitted to undergo such treatments? Would it suffice if their reasons for seeking out such treatments were simply to avoid the social stigma and related life difficulties that come along with these ways of being, or would more weighty reasons be required?
Behaviors do not come naturally labeled as “disease” and “non-disease”. Humans make those distinctions, and as various revisions of the Diagnostic and Statistical Manual of Mental Disorders reveal, we regularly change them — sometimes as a result of developing new treatments that make it possible to alter a given behaviour. What one time and culture might view as a personality quirk or as a character flaw – as something about that person’s self – another time and culture might view as a disease, disorder or mental incapacity — as a medical condition under which the person labours and which should be treated and eradicated. Using a direct brain intervention to treat refractory depression may not be controversial in many of today’s developed societies, but using one to alter sexual orientation, devout religiousness, or political leanings would be. This however need not be true in every place or time, and so the fact that a behavior may be called a “disease” cannot be considered proof that its treatment is ethically acceptable.
Furthermore, at an intuitive level there seems to be an important difference between “direct brain interventions” – e.g. drugs, electrical or magnetic stimulation, or surgery that target the brain – and more traditional ways of changing people’s minds such as through prison or psychotherapy. But can this distinction really be upheld given that we know that putting someone in prison also changes their brain, physically, even if we cannot at present pinpoint those changes? After all, if a criminal is deterred or rehabilitated, it is precisely because his brain has changed. Given this, what might be the true significance of distinguishing changing people’s minds indirectly as opposed to directly, and how should this significance be recognized and maybe even enshrined within the law?
This workshop will aim to identify what relevant direct brain intervention based techniques are currently available or on the horizon (i.e. what can be done), for what purposes they might be used or are already being used (i.e. with what aims in mind), and to assess their moral and legal permissibility (i.e. what should be permitted).
CALL FOR EXPRESSIONS OF INTEREST
Following on from two previous Capacity-Character Project workshops – the first one in Australia, and the most recent one in The Netherlands – we now invite expressions of interest from researchers and practitioners working in relevant areas who would like to participate in the workshop on the above topic, with the venue provided by the Stanford Center for Law and the Biosciences directed by Hank Greely at the Stanford Law School on September 24-26, 2012. Participants may offer to present a paper at the workshop, but expressions of interest from those wishing to just attend will also be considered:
• those wishing to just attend should send a brief letter (no more than 300 words) explaining their interest in this topic and a bio;
• those wishing to offer a paper should send a 300 word abstract and a bio.
Expressions of interest should be emailed to info (at) capacitycharacter.com by no later than July 30, 2012. Applicants will be advised in writing by August 13, 2012 of whether their expression of interest has been successful. Those offering a paper should indicate if they wish to be considered for just participating if their offer to present a paper can not be accommodated in the programme.
Places will be allocated on the basis of how well the applicants’ interests and background align with the central themes of this particular workshop and of the Capacity-Character Project. There is no registration fee, but vacancies will be strictly limited to ensure ample time for discussion, and participants must fund their own travel and accommodation.
Dr Nicole Vincent (Macquarie/TU Delft) and Prof Jeanette Kennett (Macquarie)
** This workshop’s subtitle and some text contained in the above blurb are borrowed from: Greely, H.T. (2012) Direct Brain Interventions to ‘Treat’ Disfavored Human Behaviors: Ethical and Social Issues, Clinical Pharmacology & Therapeutics, Vol 91, No 2, pp 163-5.