Sometimes one’s greatest academic disappointments can have unexpected outcomes. This is especially true when one is trying to change career trajectories or do something that others did not take seriously. My path into neuroethics was an unexpected journey catalyzed in part by constructive disappointment and the disbelief of colleagues who thought that the work I was pursuing nearly two decades prior was a fool’s errand. After all, could anyone—in his or her right mind—ever conceive of waking up a person unconscious from brain injury and getting him to speak? 1

According to a familiar distinction, neuroethics incorporates the neuroscience of ethics and the ethics of neuroscience. Within neuroethics, these two parts have provoked distinct and separate lines of inquiry, and there has been little discussion of how the two parts overlap. In the present article, I try to draw a connection between these two parts by considering the implications that are raised for ethics by scientific findings about the way we make moral decisions. The main argument of the article is that although neuroscience is “stretching” ethics by revealing the empirical basis of our moral decisions and, thereby, challenging our present understanding of the dominant ethical theories, substantial further questions remain regarding the impact that neuroscience will have on ethics more broadly.

Common understandings of neuroethics, that is, of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics, and (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism whereas the second relies on debatable assumptions about the nature of bioethics specialization and development. Informed by philosophical pragmatism and our experience in neuroethics, we argue that these claims are ill founded and should give way to pragmatist reconstructions; namely, that neuroscience, much like other areas of empirical research on morality, can provide useful information about the nature of morally problematic situations, but does not need to promise radical and sweeping changes to ethics based on neuroscientism. Furthermore, the rationale for the development of neuroethics as a specialized field need not to be premised on the distinctive nature of the issues it tackles or of neurotechnologies. Rather, it can espouse an understanding of neuroethics as both a scholarly and a practical endeavor dedicated to resolving a series of problematic situations raised by neurological and psychiatric conditions.

In this article, we present a pragmatic approach to neuroethics, referring back to John Dewey and his articulation of the “common good” and its discovery through systematic methods. Pragmatic neuroethics bridges philosophy and social sciences and, at a very basic level, considers that ethics is not dissociable from lived experiences and everyday moral choices. We reflect on the integration between empirical methods and normative questions, using as our platform recent bioethical and neuropsychological research into moral cognition, action, and experience. Finally, we present the protocol of a study concerning teenagers’ morality in everyday life, discussing our epistemological choices as an example of a pragmatic approach in empirical ethics. We hope that this article conveys that even though the scope of neuroethics is broad, it is important not to move too far from the real life encounters that give rise to moral questions in the first place.

This short article proposes a conceptual structure for “neurolaw,” modeled loosely on the bipartite division of the sister field of neuroethics by Adina Roskies into the “ethics of neuroscience” and the “neuroscience of ethics.” As normative fields addressing the implications of scientific discoveries and expanding technological capacities affecting the brain, “neurolaw” and neuroethics have followed parallel paths. Similar foundational questions arise for both about the validity and utility of recognizing them as distinct subfields of law and ethics, respectively. In both, a useful distinction can be drawn between a self-reflexive inquiry (the neuroscience of ethics and law) and an inquiry into the development and use of brain science and technologies (the ethics and law of neuroscience). In both fields, these two forms of inquiry interact in interesting ways. In addition to a proposed conceptual structure for neurolaw, the article also addresses the neurolegal versions of the critiques made against neuroethics, including charges of reductionism, fact/value confusion, and biological essentialism.

This article investigates both the claims made for, and the dangers or opportunities posed by, the development of (allegedly), aspiring or “would-be” autonomous vehicles and other artificially superintelligent machines. It also examines the dilemmas posed by the fact that these individuals might develop ideas above their station. These ideas may also limit or challenge the legitimacy of the proposed management and safety strategies that might be devised to limit the ways in which they might function or malfunction.

Highly immersive virtual reality (VR) systems have been introduced into the consumer market in recent years. The improved technological capabilities of these systems as well as the combination with biometric sensors, for example electroencephalography (EEG), in a closed-loop hybrid VR-EEG, opens up a range of new potential medical applications. This article first provides an overview of the past and current clinical applications of VR systems in neurology and psychiatry and introduces core concepts in neurophilosophy and VR research (such as agency, trust, presence, and others). Then, important adverse effects of highly immersive VR simulations and the ethical implications of standalone and hybrid VR systems for therapy in neurology and psychiatry are highlighted. These new forms of VR-based therapy may strengthen patients in exercising their autonomy. At the same time, however, these emerging systems present ethical challenges, for example in terms of moral and legal accountability in interactions involving “intelligent” hybrid VR systems. A user-centered approach that is informed by the target patients’ needs and capabilities could help to build beneficial systems for VR therapy.

Neuroscientific interventions are increasingly proposed as solutions for social problems, beyond their application in biomedicine. For example, there is increasing interest, particularly from outside commentators, in harnessing neuroscientific advances as an alternative method of punishing criminal offenders. Such neuropunishments are seen as a potentially more effective, less costly, and more humane alternative to incarceration, with overall better results for offender, communities, and societies. This article considers whether neuroscience as a field should engage more actively with such proposals, and whether more research should be done to explore the use of neurointerventions for punishment. It concludes that neuroscientists and those working at the intersection of neuroscience and the clinic should actively shape these debates.

Brain–computer interfaces (BCIs) are driven essentially by algorithms; however, the ethical role of such algorithms has so far been neglected in the ethical assessment of BCIs. The goal of this article is therefore twofold: First, it aims to offer insights into whether (and how) the problems related to the ethics of BCIs (e.g., responsibility) can be better grasped with the help of already existing work on the ethics of algorithms. As a second goal, the article explores what kinds of solutions are available in that body of scholarship, and how these solutions relate to some of the ethical questions around BCIs. In short, the article asks what lessons can be learned about the ethics of BCIs from looking at the ethics of algorithms. To achieve these goals, the article proceeds as follows. First, a brief introduction into the algorithmic background of BCIs is given. Second, the debate about epistemic concerns and the ethics of algorithms is sketched. Finally, this debate is transferred to the ethics of BCIs.

Research participants are entitled to many rights that may easily come into conflict. The most important ones are that researchers respect their autonomy as persons and act on the principles of beneficence, nonmaleficence, and justice. Since 2014, research subjects from numerous states in the United States of America also have a legal “right to try” that allows them, under certain circumstances, to receive experimental (i.e., preliminarily tested) interventions, including medical devices, before official approval from the United States Food and Drug Administration. In the context of experimental interventions, such as deep brain stimulation (DBS) for Alzheimer’s disease, this article argues that research participants ought never to have a legal “right to try” without a corresponding “right to be sure.” The latter refers to external epistemic justification construed in terms of reliance on reliable evidence. This article demonstrates that the mere complexity of intervention ensembles, as in the case of DBS for Alzheimer’s disease which serves as a paradigm example, illustrate how unanswered and/or unasked open questions give rise to a “combinatorial explosion” of uncertainties that require epistemic responses that no single research team alone is likely able to provide. From this assessment, several epistemic asymmetrical relations between researchers and participants are developed. By elucidating these epistemic asymmetries, this article unravels the reasons why open science, transparent exhaustive data reporting, preregistration, and continued constant critical appraisal via pre- and postpublication peer review are not scientific virtues of moral excellence but rather ordinary obligations of the scientific work routine required to increase reliability and strength of evidence.

Brain–computer interface (BCI) is a promising technology for restoring communication in individuals with locked-in syndrome (LIS). BCI technology offers a potential tool for individuals with impaired or absent means of effective communication to use brain activity to control an output device such as a computer keyboard. Exploratory studies of BCI devices for communication in people with LIS are underway. Research with individuals with LIS presents not only technological challenges, but ethical challenges as well. Whereas recent attention has been focused on ethical issues that arise at the initiation of studies, such as how to obtain valid consent, relatively little attention has been given to issues at the conclusion of studies. BCI research in LIS highlights one such challenge: How to decide when an exploratory BCI research study should end. In this article, we present the case of an individual with presumed LIS enrolled in an exploratory BCI study. We consider whether two common ethical frameworks for stopping randomized clinical trials—equipoise and nonexploitation—can be usefully applied to elucidating researcher obligations to end exploratory BCI research. We argue that neither framework is a good fit for exploratory BCI research. Instead, we apply recent work on clinician-researcher fiduciary obligations and in turn offer some preliminary recommendations for BCI researchers on how to end exploratory BCI studies.

Some authors have questioned the moral authority of advance directives (ADs) in cases in which it is not clear if the author of the AD is identical to the person to whom it later applies. This article focuses on the question of whether the latest results of neuroimaging studies have moral significance with regard to the moral authority of ADs in patients with disorders of consciousness (DOCs). Some neuroimaging findings could provide novel insights into the question of whether patients with DOCs exhibit sufficient psychological continuity to be ascribed diachronic personal identity. If those studies were to indicate that psychological continuity is present, they could justify the moral authority of ADs in patients with DOCs. This holds at least if respect for self-determination is considered as the foundation for the moral authority of ADs. The non-identity thesis in DOCs could no longer be applied, in line with clinical and social practice.

This article aims to explore the idea that enhancement technologies have been and will continue to be an essential element of what we might call the “human continuum,” and are indeed key to our existence and evolution into persons. Whereas conservative commentators argue that enhancement is likely to cause us to lose our humanity and become something other, it is argued here that the very opposite is true: that enhancement is the core of what and who we are. Using evidence from paleoanthropology to examine the nature of our predecessor species, and their proclivities for tool use, we can see that there is good reason to assume that the development of Homo sapiens is a direct result of the use of enhancement technologies. A case is also made for broad understandings of the scope of enhancement, based on the significant evolutionary results of acts that are usually dismissed as “unremarkable.” Furthermore, the use of enhancement by modern humans is no different than these prehistoric applications, and is likely to ultimately have similar results. There is no good reason to assume that whatever we may become will not also consider itself human.

Moral enhancement has been accused of curtailing human freedoms. In this article, I suggest the opposite: moral enhancement and individual freedom can go hand in hand. The first section defines freedom, enhancement, and morality and argues that only a naturalistic account of morality allows for the concept of enhancement. The second section looks at ways that freedom may be threatened by moral enhancement, especially by the method of implementation, the creation of new externalities, or the limitation of volitional options. I argue that virtue ethics offers the safest model for moral enhancement. The third section describes ways in which moral enhancement can be achieved while maintaining, or even increasing, individual freedom. Such methods include shifting of the moral axis, replacing vicious options with virtuous ones, and increasing the number of volitional options available. The article concludes in the fourth section by arguing that the technology and techniques that allow us moral enhancement are likely to be the same ones that allow greater freedom than we already enjoy.

Patients with repeated minor head injury are a challenge to our clinical skills of neurodiagnosis because the relevant evidence objectively demonstrating their impairment was collected in New Zealand (although published in the BMJ and Lancet) and, at the time, was mired in controversy. The effects of repeated closed diffuse head injury are increasingly recognized worldwide, but now suffer from the relentless advance of imaging technology as the dominant form of neurodiagnosis and the considerable financial interests that underpin the refusal to recognize that acute accelerational injury is the most subtle and insidiously damaging (especially when seen in the light of biopsychosocial medicine), and potentially one of the most financially momentous (given the large incomes impacted and needing compensation) phenomena in modern sports medicine. The vested interests in downplaying this phenomenon are considerable and concentrated in North America where diffuse head injury is a widespread feature of the dominant winter sports code: Gridiron or American Rules football. The relationship of this to shattered lives among the brightest and best of young men and the relatively dated objective evidence are a toxic mix in terms of ethical analysis and, therefore, there is a malignant confluence of social forces that tends toward minimizing the injury.

In this article, we begin by identifying three main neuroethical approaches: neurobioethics, empirical neuroethics, and conceptual neuroethics. Our focus is on conceptual approaches that generally emphasize the need to develop and use a methodological modus operandi for effectively linking scientific (i.e., neuroscience) and philosophical (i.e., ethics) interpretations. We explain and assess the value of conceptual neuroethics approaches and explain and defend one such approach that we propose as being particularly fruitful for addressing the various issues raised by neuroscience: fundamental neuroethics.

The body-to-head transplant (BHT) planned to be undertaken later this year at China’s Harbin Medical University by neurosurgeons Sergio Canavero and Xiaoping Ren has attracted considerable attention and criticism. The intended operation gives rise to philosophical queries about the body–brain–mind relationship and nature of the subjective self; technical and ethical issues regarding the scientific soundness, safety, and futility of the procedure; the adequacy of prior research; and the relative merit, folly, and/or danger of forging new boundaries of what is biomedically possible. Moreover, that this procedure, which has been prohibited from being undertaken in other countries, has been sanctioned in China brings into stark relief ways that differing social and political values, philosophies, ethics, and laws can affect the scope and conduct of research. Irrespective of whether the BHT actually occurs, the debate it has generated reveals and reflects both the evermore international enterprise of brain science, and the need for neuroethical discourse to include and appreciate multicultural views, values, and voices.