This paper presents newly discovered evidence from the personal correspondence of four US Nationa... more This paper presents newly discovered evidence from the personal correspondence of four US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) Genetics Panelists that their 1956 report to the public was written by a third party and was neither reviewed nor approved by the Panel prior to its publication and release to the public. The letters revealed that the 1956 Report contained serious errors and did not represent the views of the Panel. The failure of the US NAS to notify the public that the Report had not been reviewed and approved by the Panel represents a serious breach of ethics. Further ethical issues relate to the failure of the NAS to (1) correct the errors in the Report within an appropriately timely manner and (2) reveal the lack of approval by the Panel even after the Report’s release. In light of these discoveries and the profound historical—and continuing—significance of the 1956 Report to all conventional cancer-related risk assessment pro...
Advances in Neurotechnology: Ethical, Legal, and Social Issues, 2014
Effective approaches to achieve and maintain situation awareness are a fundamental underpinning o... more Effective approaches to achieve and maintain situation awareness are a fundamental underpinning of effective management of operational medical or other assets in national security and homeland security. A neuroscience-based approach to achieving situation awareness is described and contrasted with the approach proposed originally by Endsley. This neurotechnology approach regards situation assessment as analogous to interoception. It is amenable to implementation by hybrid agent-based and continuous time simulation methods for decision support applications. Both developing and potential application areas for this approach in operational medicine, disaster response planning and cybersecurity are discussed. Finally, it is noted that a neurotechnology approach reproduces key features associated with humans showing positive adaptations to adverse events: (1) the recognition of and ability to operate under conditions of uncertainty, (2) the development of a sense of connected detachment (‘integration of affect and cognition’) and (3) the recognition and acceptance of human limitations. As a result, tools based upon this approach have the potential to inculcate the wisdom that lies at the heart of resilience in the face of adversity.
New developments in deep brain stimulation (DBS) enable both openand closed-loop modulation of br... more New developments in deep brain stimulation (DBS) enable both openand closed-loop modulation of brain structures and functions that are important to the clinical treatment of a number of neuropsychiatric disorders and conditions. Ongoing clinical trials and investigator-initiated research (IIR) in DBS have generated results that expand both (1) current understanding of neural network mechanisms operative in several neuro-cognitive, emotional and behavioral processes, and (2) the potential viability and use of DBS to alter neuro-cognitive function in clinical settings, as well as for nonclinical purposes (e.g., cognitive task performance optimization and/or emotional performance alteration). It may be that we are poised upon new horizons of possibility to employ DBS (and other neuromodulatory technologies) as treatment of brain disease, disorder, and injury, and to facilitate and/or enhance defined aspects of human thought and behavior. Frederic Gilbert (2015) revisits several fundamental neuroethical issues and questions arising from the use of interventional neurotechnology in light of these new developments in DBS. As Gilbert notes, many neuropsychiatric conditions impair patients’ sense of agency and autonomy. This fosters interest in the viability and value of DBS in restoring self-determination, and often is a strong motivation for patients seeking such treatment in the first place. Such desires can also be fueled, at least in part, by the relative “push” of a growing technological trend—what has been regarded as a technological imperative—in neuroscience and its clinical translation and applications in neurology and psychiatry. Additionally, there is an equal, if not greater, “pulling” force exerted by increasing demand-side influences and market valuation of neurotechnology (Giordano and Benedikter 2013). On one hand, patients and the public may be seduced by the lure of new technology, and may misrepresent the potential benefits that can realistically be gained. On the other, patients and the public may be intimidated by (if not frankly fearful of) possibilities for “mind control” and other deleterious (or unanticipated) effects (Giordano 2012). Thus, at the core is a need for realistic determination, and communication, of the actual capabilities and limitations of DBS or any neurotechnology (Giordano 2015). Before a neurotechnology can be advocated for use, it is essential that clinicians address a number of key questions (i.e., the “6-Ws”) that must then be framed within specific domains and dimensions of utility and effect (i.e., the “6-Cs”). This approach entails and obtains detailed assessment of the nature, intent, and realistic effect(s) and consequences of the treatment; settings and contexts of use and outcomes; how intervention can and likely will incur both the therapeutic end goal(s) and other aspects of patients’ cognitive and emotional status; and the needs for, and assurances of, continuity of clinical care and
Advances made by twentieth century medicine have positively impacted the public health by reducin... more Advances made by twentieth century medicine have positively impacted the public health by reducing mortality, but have also led to an increased morbidity of chronic diseases and longitudinal illness. Such illness is often refractory to the curative medical model, but is frequently responsive to more healing approaches, including those that fall within the rubric of mind-body medicine. Recently many of these approaches (e.g.- placebo responses, meditation, yoga, etc.) have been viewed with appreciation by the research and clinical communities, and this has evoked considerable public interest in, and use of such techniques. Compelling questions persist regarding the outcomes, mechanisms, applications and limitations of these approaches and effects, reinforcing the need for research that is compelled by clinical questions, methodologically rigorous, yet responsive to the special demands of addressing the underlying hard question(s) of conscious processes. Thus, we maintain that researc...
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees, 2016
An integrated and principled neuroethics offers ethical guidelines able to transcend conventional... more An integrated and principled neuroethics offers ethical guidelines able to transcend conventional and medical reliance on normality standards. Elsewhere we have proposed four principles for wise guidance on human transformations. Principles like these are already urgently needed, as bio- and cyberenhancements are rapidly emerging. Context matters. Neither "treatments" nor "enhancements" are objectively identifiable apart from performance expectations, social contexts, and civic orders. Lessons learned from disability studies about enablement and inclusion suggest a fresh way to categorize modifications to the body and its performance. The term "enhancement" should be broken apart to permit recognition of enablements and augmentations, and kinds of radical augmentation for specialized performance. Augmentations affecting the self, self-worth, and self-identity of persons require heightened ethical scrutiny. Reversibility becomes the core problem, not the...
After a decade of growth and development, neuroethics as a defined discipline is establishing dom... more After a decade of growth and development, neuroethics as a defined discipline is establishing domains of inquiry and action, a defined canon, and set(s) of practices. Neuroethical address and discourse must engage the realities forged and fostered by brain science no matter where they emerge and deliberate upon neurotechnological applications on the international scale. The invention and application of neurotechnologies are raising questions of ethics, to be sure. Neuroscientific innovations are also altering and challenging how we regard ourselves as moral beings worthy of ethical standing. Neuroethical investigations, at the empirical levels of experimental research and clinical application or the philosophical levels of exploring moral capacities or ethical issues, concern ideas of what it means to be human and ideals of humanity-wide importance. As a discipline and in practice, neuroethics must heed the subjective realities of the people who take part in neuroscientific research and therapy. No single method could do justice to understanding ourselves as persons, nor could any single country monopolize the meaning of self-identity and self-worth. Therefore, neuroethics must become “disciplined” to be realized as genuinely intercultural, as well as thoroughly interconnected. We find that these goals and tasks are already being achieved through multidisciplinary and multinational networked teams that conduct collaborative inquiries in specific areas of both local and global concern. These teams deserve attention and appreciation as exemplars for future disciplinary progress in neuroethics.
The possibility of a human head transplant poses unprecedented philosophical and neuroethical que... more The possibility of a human head transplant poses unprecedented philosophical and neuroethical questions. Principal among them are the personal identity of the resultant individual, her metaphysical and social status: Who will she be and how should the “new” person be treated - morally, legally and socially - given that she incorporates characteristics of two distinct, previously unrelated individuals, and possess both old and new physical, psychological, and social experiences that would not have been available without the transplant? We contend that this situation challenges linguistic conventions and conceptual binaries (“part-whole”), and calls into question the major philosophical approaches to personal identity: animalism and reductionism. We examine these views critically vis-a-vis head transplantation and conclude that they fail to provide an adequate account of the identity of the resultant individual because both neglect the key role of embodiment for personal identity. We maintain that embodiment is central to personal identity and a radical alteration of the body will also radically alter that person, making her a different person. Consequently, a human head transplant will result in an individual partly continuous with the head/brain (in terms of connected memories and mental events), and partly continuous with the body donor (in terms of the inputs and regulatory patterns afforded by the structure and functions of the nervous system, and the self-image of this new embodiment). We conclude that the resultant person would be different from both the individual whose head was transplanted and the one to whose body the “new” head is attached.
Dr. Edward Calabrese asserts that hormetic responses occur in neural systems, and provides ample ... more Dr. Edward Calabrese asserts that hormetic responses occur in neural systems, and provides ample review of evidence to support this claim. In this essay, we survey Dr. Calabrese's findings, illustrate the somewhat provocative premise of hormesis, and posit that while evidence suggests that amplification of low-dose effects are operative in neural systems, it is equally important to consider observations and claims of hormesis in greater detail, and framed within the "cultural" and epistemic contexts of science. We offer specific caveats to avoid the overgeneralization of findings, oversimplification of putative effects or mechanisms, and the dogmatic adherence to a restrictive methodologic orientation. Finally, we assert that any meaningful discussion of hormesis must be grounded to methodologic rigor, yet openness, and must allow for a self-critical and self-revisionist epistemic approach. We attempt to show that the work presented by Calabrese takes a first and important step toward the initiation of dialectic, allows for the exchange of ideas, strives toward reconciliation of differences and the amelioration of error, and seeks intellectual synthesis.
Introduction: Chronic Pain and Depression Advancing knowledge to resolve the enigma of chronic pa... more Introduction: Chronic Pain and Depression Advancing knowledge to resolve the enigma of chronic pain was a major impetus for the dedication of intellectual and technical efforts that were the focus of the congressionally declared Decade of Pain Control and Research. Yet despite ...
This paper presents newly discovered evidence from the personal correspondence of four US Nationa... more This paper presents newly discovered evidence from the personal correspondence of four US National Academy of Sciences (NAS) Biological Effects of Atomic Radiation (BEAR) Genetics Panelists that their 1956 report to the public was written by a third party and was neither reviewed nor approved by the Panel prior to its publication and release to the public. The letters revealed that the 1956 Report contained serious errors and did not represent the views of the Panel. The failure of the US NAS to notify the public that the Report had not been reviewed and approved by the Panel represents a serious breach of ethics. Further ethical issues relate to the failure of the NAS to (1) correct the errors in the Report within an appropriately timely manner and (2) reveal the lack of approval by the Panel even after the Report’s release. In light of these discoveries and the profound historical—and continuing—significance of the 1956 Report to all conventional cancer-related risk assessment pro...
Advances in Neurotechnology: Ethical, Legal, and Social Issues, 2014
Effective approaches to achieve and maintain situation awareness are a fundamental underpinning o... more Effective approaches to achieve and maintain situation awareness are a fundamental underpinning of effective management of operational medical or other assets in national security and homeland security. A neuroscience-based approach to achieving situation awareness is described and contrasted with the approach proposed originally by Endsley. This neurotechnology approach regards situation assessment as analogous to interoception. It is amenable to implementation by hybrid agent-based and continuous time simulation methods for decision support applications. Both developing and potential application areas for this approach in operational medicine, disaster response planning and cybersecurity are discussed. Finally, it is noted that a neurotechnology approach reproduces key features associated with humans showing positive adaptations to adverse events: (1) the recognition of and ability to operate under conditions of uncertainty, (2) the development of a sense of connected detachment (‘integration of affect and cognition’) and (3) the recognition and acceptance of human limitations. As a result, tools based upon this approach have the potential to inculcate the wisdom that lies at the heart of resilience in the face of adversity.
New developments in deep brain stimulation (DBS) enable both openand closed-loop modulation of br... more New developments in deep brain stimulation (DBS) enable both openand closed-loop modulation of brain structures and functions that are important to the clinical treatment of a number of neuropsychiatric disorders and conditions. Ongoing clinical trials and investigator-initiated research (IIR) in DBS have generated results that expand both (1) current understanding of neural network mechanisms operative in several neuro-cognitive, emotional and behavioral processes, and (2) the potential viability and use of DBS to alter neuro-cognitive function in clinical settings, as well as for nonclinical purposes (e.g., cognitive task performance optimization and/or emotional performance alteration). It may be that we are poised upon new horizons of possibility to employ DBS (and other neuromodulatory technologies) as treatment of brain disease, disorder, and injury, and to facilitate and/or enhance defined aspects of human thought and behavior. Frederic Gilbert (2015) revisits several fundamental neuroethical issues and questions arising from the use of interventional neurotechnology in light of these new developments in DBS. As Gilbert notes, many neuropsychiatric conditions impair patients’ sense of agency and autonomy. This fosters interest in the viability and value of DBS in restoring self-determination, and often is a strong motivation for patients seeking such treatment in the first place. Such desires can also be fueled, at least in part, by the relative “push” of a growing technological trend—what has been regarded as a technological imperative—in neuroscience and its clinical translation and applications in neurology and psychiatry. Additionally, there is an equal, if not greater, “pulling” force exerted by increasing demand-side influences and market valuation of neurotechnology (Giordano and Benedikter 2013). On one hand, patients and the public may be seduced by the lure of new technology, and may misrepresent the potential benefits that can realistically be gained. On the other, patients and the public may be intimidated by (if not frankly fearful of) possibilities for “mind control” and other deleterious (or unanticipated) effects (Giordano 2012). Thus, at the core is a need for realistic determination, and communication, of the actual capabilities and limitations of DBS or any neurotechnology (Giordano 2015). Before a neurotechnology can be advocated for use, it is essential that clinicians address a number of key questions (i.e., the “6-Ws”) that must then be framed within specific domains and dimensions of utility and effect (i.e., the “6-Cs”). This approach entails and obtains detailed assessment of the nature, intent, and realistic effect(s) and consequences of the treatment; settings and contexts of use and outcomes; how intervention can and likely will incur both the therapeutic end goal(s) and other aspects of patients’ cognitive and emotional status; and the needs for, and assurances of, continuity of clinical care and
Advances made by twentieth century medicine have positively impacted the public health by reducin... more Advances made by twentieth century medicine have positively impacted the public health by reducing mortality, but have also led to an increased morbidity of chronic diseases and longitudinal illness. Such illness is often refractory to the curative medical model, but is frequently responsive to more healing approaches, including those that fall within the rubric of mind-body medicine. Recently many of these approaches (e.g.- placebo responses, meditation, yoga, etc.) have been viewed with appreciation by the research and clinical communities, and this has evoked considerable public interest in, and use of such techniques. Compelling questions persist regarding the outcomes, mechanisms, applications and limitations of these approaches and effects, reinforcing the need for research that is compelled by clinical questions, methodologically rigorous, yet responsive to the special demands of addressing the underlying hard question(s) of conscious processes. Thus, we maintain that researc...
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees, 2016
An integrated and principled neuroethics offers ethical guidelines able to transcend conventional... more An integrated and principled neuroethics offers ethical guidelines able to transcend conventional and medical reliance on normality standards. Elsewhere we have proposed four principles for wise guidance on human transformations. Principles like these are already urgently needed, as bio- and cyberenhancements are rapidly emerging. Context matters. Neither "treatments" nor "enhancements" are objectively identifiable apart from performance expectations, social contexts, and civic orders. Lessons learned from disability studies about enablement and inclusion suggest a fresh way to categorize modifications to the body and its performance. The term "enhancement" should be broken apart to permit recognition of enablements and augmentations, and kinds of radical augmentation for specialized performance. Augmentations affecting the self, self-worth, and self-identity of persons require heightened ethical scrutiny. Reversibility becomes the core problem, not the...
After a decade of growth and development, neuroethics as a defined discipline is establishing dom... more After a decade of growth and development, neuroethics as a defined discipline is establishing domains of inquiry and action, a defined canon, and set(s) of practices. Neuroethical address and discourse must engage the realities forged and fostered by brain science no matter where they emerge and deliberate upon neurotechnological applications on the international scale. The invention and application of neurotechnologies are raising questions of ethics, to be sure. Neuroscientific innovations are also altering and challenging how we regard ourselves as moral beings worthy of ethical standing. Neuroethical investigations, at the empirical levels of experimental research and clinical application or the philosophical levels of exploring moral capacities or ethical issues, concern ideas of what it means to be human and ideals of humanity-wide importance. As a discipline and in practice, neuroethics must heed the subjective realities of the people who take part in neuroscientific research and therapy. No single method could do justice to understanding ourselves as persons, nor could any single country monopolize the meaning of self-identity and self-worth. Therefore, neuroethics must become “disciplined” to be realized as genuinely intercultural, as well as thoroughly interconnected. We find that these goals and tasks are already being achieved through multidisciplinary and multinational networked teams that conduct collaborative inquiries in specific areas of both local and global concern. These teams deserve attention and appreciation as exemplars for future disciplinary progress in neuroethics.
The possibility of a human head transplant poses unprecedented philosophical and neuroethical que... more The possibility of a human head transplant poses unprecedented philosophical and neuroethical questions. Principal among them are the personal identity of the resultant individual, her metaphysical and social status: Who will she be and how should the “new” person be treated - morally, legally and socially - given that she incorporates characteristics of two distinct, previously unrelated individuals, and possess both old and new physical, psychological, and social experiences that would not have been available without the transplant? We contend that this situation challenges linguistic conventions and conceptual binaries (“part-whole”), and calls into question the major philosophical approaches to personal identity: animalism and reductionism. We examine these views critically vis-a-vis head transplantation and conclude that they fail to provide an adequate account of the identity of the resultant individual because both neglect the key role of embodiment for personal identity. We maintain that embodiment is central to personal identity and a radical alteration of the body will also radically alter that person, making her a different person. Consequently, a human head transplant will result in an individual partly continuous with the head/brain (in terms of connected memories and mental events), and partly continuous with the body donor (in terms of the inputs and regulatory patterns afforded by the structure and functions of the nervous system, and the self-image of this new embodiment). We conclude that the resultant person would be different from both the individual whose head was transplanted and the one to whose body the “new” head is attached.
Dr. Edward Calabrese asserts that hormetic responses occur in neural systems, and provides ample ... more Dr. Edward Calabrese asserts that hormetic responses occur in neural systems, and provides ample review of evidence to support this claim. In this essay, we survey Dr. Calabrese's findings, illustrate the somewhat provocative premise of hormesis, and posit that while evidence suggests that amplification of low-dose effects are operative in neural systems, it is equally important to consider observations and claims of hormesis in greater detail, and framed within the "cultural" and epistemic contexts of science. We offer specific caveats to avoid the overgeneralization of findings, oversimplification of putative effects or mechanisms, and the dogmatic adherence to a restrictive methodologic orientation. Finally, we assert that any meaningful discussion of hormesis must be grounded to methodologic rigor, yet openness, and must allow for a self-critical and self-revisionist epistemic approach. We attempt to show that the work presented by Calabrese takes a first and important step toward the initiation of dialectic, allows for the exchange of ideas, strives toward reconciliation of differences and the amelioration of error, and seeks intellectual synthesis.
Introduction: Chronic Pain and Depression Advancing knowledge to resolve the enigma of chronic pa... more Introduction: Chronic Pain and Depression Advancing knowledge to resolve the enigma of chronic pain was a major impetus for the dedication of intellectual and technical efforts that were the focus of the congressionally declared Decade of Pain Control and Research. Yet despite ...
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Papers by James Giordano