Zooming out from the brain to foster translational neuroethics

The Version of Record of this manuscript has been published and is available in AJOB Neuroscience on September, 2023. 

In their valuable call-for-action paper, Wexler and Specker Sullivan (2021) propose an integration-inclusion-impact axis for “translational neuroethics,” to face the challenges and criticisms that neuroethics has aroused in its initial stages and to take the discipline into the future. One aspect mentioned by the authors is the interdisciplinary nature of neuroethics, in which academics with theoretical and empirical approaches converge. We propose to elaborate on this idea stressing the need to work on a fundamental neuroethics (Evers 2007) that, in our opinion, should “zoom out” from neuroessentialist and cerebrocentric views, thus increasing integration and inclusion.

In their look back to the discipline, Wexler and Specker Sullivan picture a portrait of neuroethics that is “uncritical,” “pessimistic,” and “predictably formulaic” (Wexler and Specker Sullivan 2021, 2). This is partly due to neuroethics reflecting “a somewhat narrow set of values and perspectives, often focusing on emerging neuroscientific and neurotechnological developments” (Wexler and Specker Sullivan 2021, 3). According to them, “Without careful consideration of what is an appropriate neuroethics question, neuroethics will continue to replicate patterns in scientific discourse that are unjust due to disproportionate attention to certain perspectives and lack of consideration of others” (Wexler and Specker Sullivan 2021, 3). To mitigate this, they propose boosting translational neuroethics (i.e., moving neuroethics from theoretical reflection to practice) by promoting integration and inclusivity, increasing impact. Integration refers to the closeness that neuroethics should have with neuroscience, clinical sciences, and technology. Inclusivity is intended to diversify perspectives to avoid bias. We agree with these ideas, both the critiques and possible solutions. However, we want to take them to a deeper, even radical, standpoint.

Mainstream neuroscience is, in our opinion, neuro-essentialist (Reiner 2011), cerebrocentric (Fuchs 2021a), and adopts reductive materialism by default (Churchland 2013). These are three metaphysical (philosophical) interconnected perspectives. The first refers to arguing that the only important aspect of the human person is the nervous system; the second is the reduction of the nervous system (and therefore the person) to the brain; and the third states that the only existing reality of human beings is their bodies, being mental activity a mere epiphenomenon (i.e., a primarily valueless byproduct). According to us, mainstream neuroethics accepts these rules for the game, and therefore its translation into practical issues is biased to a predominant, but not the only, way of thinking. Hence, inclusion is at stake.

Wexler and Specker Sullivan (2021, 8) admit that “there is a role for theoretical and conceptual debate about norms and [we] do not intend our advocacy of translational ethics to suggest that only translational work is valuable”. In line with this remark, we think that, rather than default to a specific approach (i.e., reductive materialism) on the relationship of the brain and nervous system to mental states, neuroethics should more vigorously embrace the fundamental neuroethics research agenda. According to Evers (2007, S48), fundamental neuroethics investigates how knowledge of the functional architecture of the brain and its evolution can increase our understanding of personal identity, consciousness and intentionality, including the development of moral thought and judgement. Fundamental neuroethics therefore provides applied neuroethics with the theoretical foundations needed to address ethical problems of applying neurological science.

Thus, the problems traditionally studied by the philosophy of mind and action should be part of discussions in neuroethics, instead of neuroethicists assuming starting positions based on the dominant current of thought in these disciplines.

Proponents of reductive materialism put Cartesian dualism (i.e., body and mind are entirely independent entities, but they somewhat interact) as the only alternative to their proposal. However, this is not the case. There are embodied, enactive, extended, and embedded accounts (currently grouped as so-called 4E proposals) (see Newen, De Bruin, and Gallagher 2018) that are being refined to reach a more comprehensive understanding of the brain and the nervous system within the human person, including their life-history and social selves. This may have very relevant and straightforward implications for “translational neuroethics.” For example, philosopher and psychiatrist Thomas Fuchs has proposed a re-interpretation of the concept and treatment of various disorders, such as dementia (Fuchs 2020) and anorexia (Fuchs 2021b), based on his proposal of the brain as a mediating organ of the person. The study of consciousness also benefits from these holistic proposals, with clear resonance in clinical science and neurotechnology. In this regard, philosopher and neuroscientist Georg Northoff has his theory of consciousness pinpointed in the world-brain relationship (Northoff 2023). Moreover, a computer scientist and philosopher, Tom Froese has recently proposed the “irruption theory of consciousness.” Its central point consists of understanding adaptive behavior through its intrinsic (yet nonreductive) relationship with unpredictable neural activity (Froese 2023). Finally, recent empirical evidence shows that intersubjective experiences can be essential in shaping certain brain networks (see, for example, Kohler et al. 2023).

The above are just four examples to show that there are very elaborate alternatives to reductive materialism beyond ingenuous dualism, and they can strongly impact clinical practice and technology.

We have stressed the background of these researchers because it is at the core of our message, as we will clarify later. Before that, let us summarize our train of thought:

• (1) Any interpretation of neuroscientific facts entails a particular way of understanding the nervous system, that is, a philosophical –or fundamental– view of the brain;
• (2) Mainstream neuroscience acritically assumes reductive materialism as philosophical view;
• (3) Mainstream neuroethics also assumes this perspective, and mainly concentrates on translational issues, instead of considering fundamental neuroethics;
• (4) A richer understanding of the nervous system, incorporating the whole body, mental activity, life history, and intersubjectivity as co-essential features of the person, may be beneficial for a more inclusive, integrated, and impactful neuroethics.

This is an ambitious program, and true interdisciplinarity is the cornerstone. As well pointed out by Wexler and Specker Sullivan (2021, 6), there is a need “to increase diversity within the field by encouraging researchers from different types of backgrounds to engage with ethical issues in neuroscience.” For this reason, we believe that a deeper understanding of the neural system may be possible by training researchers with a strong background in empirical neuroscience who also master different aspects of philosophy, psychology, or sociology, among others. This is not impossible: successful researchers like Fuchs, Northoff, and Froese are already doing it.

Nevertheless, institutional support is essential for such a “quixotic” endeavor. In 2021, the Spanish private heritage Tatiana Foundation created the International Center for Neuroscience and Ethics (CINET),[1] the larger project on the ethical implications of neuroscience in Spain. CINET promotes interdisciplinarity in order to better understand the real brain, that is, as part of a nervous system embedded in a person with their history and environment. To do so, CINET offers cross-disciplinary postdoctoral fellowships, organizes international workshops with top-leading researchers on the mind-brain problem, has launched a research program on synchrony as an essential trait of living beings, and holds various disseminative and outreach events for a general audience, technological companies, law schools, journalists, and other stakeholders.

Our approach to ethics is bottom-up, contributing to a better understanding of the ethical challenges of neuroscience from a more profound knowledge of the real brain. The strength of this strategy is to create diversity, that is, to promote original approaches to neuroethical issues based on creative (but well-founded) ways of understanding the brain. For this strategy to be successful, more inclusive neuroethics is essential, as proposed by Wexler and Specker Sullivan (2021). Inclusion and integration entail zooming out from the brain to foster more impactful fundamental and translational neuroethics.

[1] See https://www.cinetcenter.com/en/

Authors

José M. Muñoz. University of California, Berkeley, CA, United States. International Center of Neuroscience and Ethics (CINET), Madrid, Spain

Javier Bernacer. Mind-Brain Group, Institute for Culture and Society (ICS). University of Navarra, Pamplona, Spain. International Center of Neuroscience and Ethics (CINET), Madrid, Spain.

Acknowledgments

Both authors are grateful to the Tatiana Foundation (https://www.fundaciontatiana.com/en/) for its valuable support of their research.

Declaration of interest

The authors report there are no competing interests to declare.

References

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