Neuroethics & Law Blog

Pain Control Using fMRI

A couple of days ago, the NYT ran an article  on the use of real-time functional magnetic resonance imaging (fMRI) to treat pain and perhaps a host of other symptoms like addiction and depression.  The technology works like a kind of high-tech biofeedback:

Here’s how Omneuron uses fMRI to treat chronic pain: A patient slides into the coffin-like scanner and watches a computer-generated flame projected on the screen of virtual-reality goggles; the flame’s intensity reflects the neural activity of regions of the brain involved in the perception of pain. Using a variety of mental techniques — for instance, imagining that a painful area is being flooded with soothing chemicals — most people can, with a little concentration, make the flame wax or wane. As the flame wanes, the patient feels better. Superficially similar to an older technology, electroencephalogram biofeedback, which measures electrical feedback across multiple areas of the brain, fMRI feedback measures the blood flow in precise areas of the brain.

By giving users feedback about their pain, the technique attempts to create a visual representation of an individual's pain.  That's pretty impressive!  But imagine if we could make interpersonal judgments of pain.  That could really change the way we identify malingerers and the way we calculate damages in court.  As I've noted, I think that new neurotechnologies may someday move us in that direction.

Abortion, Persuasion, and Emotion

Jeremy A. Blumenthal (Syracuse University, Law), a former guest of the Neuroethics & Law Blog, has posted Abortion, Persuasion, and Emotion: Implications of Social Science Research on Emotion for Reading Casey (Washington Law Review, Vol. 83, Feb. 2008) to SSRN. Here is the abstract:

Although abortion jurisprudence under Casey condones State efforts to persuade a woman to forego an abortion in favor of childbirth, the opinion's “truthful and not misleading” language can be read more broadly than it traditionally has. Specifically, even a truthful message may mislead when it inappropriately takes advantage of emotional influence to bias an individual's decision away from the decision that would be made in a non-emotional, fully informed, state. Drawing on the insights of empirical research in the social sciences, I suggest that the sort of emotional information that many States now provide in their “informed consent” statutes can lead to such inappropriate emotional influence, and thus should be examined more closely than heretofore. This broader reading, taking into account empirical research that gives a better idea of individual decision-making, suggests that States' informed consent statutes have the potential to be an impermissible burden on the exercise of a woman's autonomous decision-making about an abortion precisely because they are calculated to bias a woman's free choice, not inform it.

Jeremy A. Blumenthal (Syracuse University, Law), a former guest of the Neuroethics & Law Blog, has posted Abortion, Persuasion, and Emotion: Implications of Social Science Research on Emotion for Reading Casey (Washington Law Review, Vol. 83, Feb. 2008) to SSRN. Here is the abstract:

Although abortion jurisprudence under Casey condones State efforts to persuade a woman to forego an abortion in favor of childbirth, the opinion's “truthful and not misleading” language can be read more broadly than it traditionally has. Specifically, even a truthful message may mislead when it inappropriately takes advantage of emotional influence to bias an individual's decision away from the decision that would be made in a non-emotional, fully informed, state. Drawing on the insights of empirical research in the social sciences, I suggest that the sort of emotional information that many States now provide in their “informed consent” statutes can lead to such inappropriate emotional influence, and thus should be examined more closely than heretofore. This broader reading, taking into account empirical research that gives a better idea of individual decision-making, suggests that States' informed consent statutes have the potential to be an impermissible burden on the exercise of a woman's autonomous decision-making about an abortion precisely because they are calculated to bias a woman's free choice, not inform it.

Ethics, Neuroimaging, and Limited States of Consciousness: Audio files available (Murphy)

The audio files from the morning lectures of the June 28th "Ethics, Neuroimaging, and Limited States of Consciousness" are available at the Stanford Neuroethics website.  Part I is Al Jonsen, Part II is Joseph Fins (with commentators), and Part III is David Magnus (with commentators).  See the post below for an outline.

Bloom's "Best of the Brain"--Updated

The Dana Press has recently sent me the new book, Best of the Brain From Scientific American.  Edited by Floyd Bloom, esteemed neuroscientist and member of the President's Council on Bioethics, the book contains more than twenty articles related to the mind and brain from past issues of Scientific American.  The book is appealing both for its substantive content and its aesthetic illustrations and layout. (Here's a link to the book on Amazon.)

UPDATE: You can find a review of this book here.  Other neuroethics-related books are reviewed here, here, here, and here.

A Limited Defense of Clinical Placebo Deception

You may be surprised to learn that doctors sometimes give patients pure placebos (like sugar pills or saline injections) and claim or misleadingly suggest that the patient is receiving an active medication.  While this practice is probably on the decline, many doctors prescribe active medications (like antibiotics) for symptoms that they know the active medication doesn't treat.  In both kinds of cases, patient symptoms may improve by way of a placebo effect.  By deceiving the patient, however, the improvement arguably comes at an unacceptable cost.  Interestingly, there are virtually no published cases discussing whether the deceptive administration of placebos violates obligations to obtain patient informed consent.

The American Medical Association has recently revised its ethics policies to prohibit doctors from deceptively administering placebos.  This categorical prohibition paints with a rather broad brush, however.  In a forthcoming article in the Yale Law and Policy Review, I offer a limited defense of clinical placebo deception.  Here is the abstract (scroll down to download the full text).  The article is still in draft form, and I welcome comments on the piece by email. (X-posted here).

Neuromatrix Educational Video

Former guest blogger Caitlin Connors refers me to this link to "Neuromatrix," an educational video game designed to teach neuroscience to 10-15 year olds.  (Some more information here.)

The Simulation Argument

An article in yesterday's New York Times discusses the possibility that our world was created as a hobby or as an experiment by members of some more technologically advanced civilization.  It's the sort of late-night-type discussion you probably had in college.  The twist comes from a discussion with the-always-insightful Nick Bostrom, Director of the Future of Humanity Institute at Oxford University:

Dr. Bostrom assumes that technological advances could produce a computer with more processing power than all the brains in the world, and that advanced humans, or “posthumans,” could run “ancestor simulations” of their evolutionary history by creating virtual worlds inhabited by virtual people with fully developed virtual nervous systems.

Some computer experts have projected, based on trends in processing power, that we will have such a computer by the middle of this century, but it doesn’t matter for Dr. Bostrom’s argument whether it takes 50 years or 5 million years. If civilization survived long enough to reach that stage, and if the posthumans were to run lots of simulations for research purposes or entertainment, then the number of virtual ancestors they created would be vastly greater than the number of real ancestors. [emphasis added by AK]

There would be no way for any of these ancestors to know for sure whether they were virtual or real, because the sights and feelings they’d experience would be indistinguishable. But since there would be so many more virtual ancestors, any individual could figure that the odds made it nearly certain that he or she was living in a virtual world.

Of course, there are lots of caveats, and Bostrom later offers his gut feeling that there's a 20% chance that we're living in a computer simulation.  So, how do you live in a world where you might be part of a computer simulation? I suppose you live according to whatever the simulation has established for you.  (Do simulated humans make choices the way that we think we do?)  Here's some advice from the article that you will likely find less-than-entirely persuasive:

A more practical question is how to behave in a computer simulation. Your first impulse might be to say nothing matters anymore because nothing’s real. But just because your neural circuits are made of silicon (or whatever posthumans would use in their computers) instead of carbon doesn’t mean your feelings are any less real.

Undergraduate Neuroethics Papers

The Neuroethics Society and the Penn Bioethics Journal (PBJ) are offering prizes to top undergraduate neuroethics papers:

Submissions will be reviewed by the Editorial Board of PBJ, which will select 6 semifinalists, and a committee of Neuroethics Society members, which will select the winning paper and 2 runners up.  The author of the winning paper and the runners up will receive cash prizes of $300 and $100 each, respectively, and framed citations.  All three papers will be published in PBJ.  In addition, some or all of the other semifinalists will also be published in PBJ as space permits.

Details here.

Upcoming Academic Conferences in Various Fields

In the legal academy, I sometimes receive announcements for conferences a few days before the conference is about to start.  To help stay abreast of what's coming up, you may want to look here or here.  For academics of all stripes, you may want to check out this site, which lists upcoming conferences all over the world in a variety of fields.  I have added all three of these websites to the Neuroethics & Law Blog's list of "Other Sites" on the left-hand column of your screen.

Neuroscience Journalism In Review

The Neuro-Journalism Mill is a new blog from the McDonnell Foundation dedicated to "[s]eparating the wheat from the chaff of media reporting on brain science."  There's some discussion of the blog here and here.

Deep Brain Stimulation Helps Man Regain Speech

A man in a minimally conscious state, who has not spoken for six years, has regained the ability to speak after being treated with deep brain stimulation.  Here's the story and here's an excerpt:

The man described in the Nature study speaks in a breathy but audible voice, said Dr. Joseph Giacino, a co-lead author. He does not initiate conversations but can reply to others, typically with one to three words, said Giacino, of the JFK Johnson Rehabilitation Institute in Edison, N.J.

Several weeks ago he recited the first half of the Pledge of Allegiance without assistance, Giacino said.

The man also recovered some movement. He can demonstrate motions such as brushing his teeth, said study lead author Dr. Nicholas Schiff of Weill Cornell Medical College in New York. He can't actually carry out that task because the tendons in his arms contracted after years of immobility.