A Conversation with Martha Farah on Neuroethics

Science writer Karen A. Frenkel interviews neuroscientist Martha Farah for the FPR.

Martha J. Farah is the Walter H. Annenberg Professor of Natural Sciences and Director, Center for Neuroscience and Society at the University of Pennsylvania. She is the author and editor of many books about neuroscience and has received many awards. Most recently, the Association for Psychological Science honored her with its 2009 Lifetime Achievement Award. Below, Professor Farah discusses neuroethics in general and responds to questions inspired by her new book, Neuroethics: An Introduction with Readings (MIT Press, August, 2010).

KAF: You’ve been involved in cognitive neuroscience since its beginning three decades ago. What is the greatest change in the field you have witnessed during those years?

MJF: It’s hard to point to just one thing, so much has happened in the last 30 years: functional imaging of cognition, computational models linking single neuron behavior with the functioning of large-scale networks in the brain, the extension of the cognitive neuroscience approach into the study of social and emotional functions. . . .  Maybe the best way to answer the question is to say this: We went from having neuroscience and cognitive science as two separate disciplines to having a truly integrated study of mind and brain.

KAF: You raise many ethical questions in your new book. Do you think the differences between Western and East Asian cultures, which cultural neuroscience literature characterizes as “individualistic” or “independent” (Western), and “collectivistic” or “interdependent” (East Asian), yield different ideas about what constitutes ethical neuroscience?

MJF: That’s an interesting question, to which I wish I knew the answer. Although there are Asian scientists writing on neuroethics, I have not seen these differences crop up, but I also have not been especially attuned to them. It seems clear that this issue of individuality and self-determination does figure in some of the arguments in neuroethics in the West, for example the ethics of brain enhancement. Proponents of enhancement tend to argue that the decision of whether to enhance one’s own brain should be a matter of personal choice, and emphasize the benefits to society of having individuals who are smarter, cheerier, or whatever. It would be interesting to know if these arguments are less persuasive in the East.

KAF: Why should neuroscience students, who intend to conduct research, be concerned with neuroethical issues?

MJF: I don’t think we can do a complete “division of labor” on science and ethics, and assume that our colleagues over in the IRB (Institutional Review Board, which reviews research on human subjects for risk/benefit issues) or the Bioethics Department will worry about the ethics so we don’t have to. Everything we do as scientists – the choice of research question, the methods we use, the way we communicate the results and, in some cases, the way we partner with private interests – all have ethical implications. To be sure, for some topics and at some stages of development these implications will be quite distant and removed from the current scientific realities. But to recognize the ethically consequential decisions and to be prepared for them, we need to have some background. That’s why I encourage neuroscience graduate students to learn about neuroethics.

KAF: Why should lay people be interested?

MJF: Because ready or not, neuroscience is increasingly influencing our lives. People need to be informed consumers of neurotechnology and of neuroscience ideas and claims. We have TV doctors pushing brain imaging as the ultimate way to diagnose mental disorders and even assess marital compatibility. We have school systems investing their limited budgets in supposedly brain-based educational programs. As a neuroscientist, I am very skeptical about these products and services. Unfortunately, most people know nothing about neuroscience and just say “it sounds scientific, it must be good.” A greater familiarity with what neuroscience can and cannot do would protect people by, at the very minimum, leading them to ask some questions before buying, like “what is the evidence that this works?”

The lack of public understanding can work both ways, making people gullible and accepting, but also leading them to reject worthwhile options because those options are unfamiliar and sound like science fiction or Huxley’s Brave New World. For example, some people will not even consider medication for themselves or their kids to help with psychiatric disorders, because the idea of changing one’s brain chemistry sounds wrong, or because they consider such medicines in the same category as street drugs.

KAF: In your chapter “Better Brains,” you write about the neuroethics of neuroenhancement and its inevitability. Why is it inevitable and what are the pros and cons?

MJF: I think it’s inevitable because human nature leads us to try to improve ourselves and to look for shortcuts, and neuroenhancement plays to both of those desires. Early adopters will be strivers with low risk aversion, but once those types start openly using enhancements, then – assuming no horrible side effects show up – the rest of us will say “why not, let’s give it a try,” or even, “I don’t want to, but with everyone else at work doing it, I had better also to keep my job.”

You can see this kind of progression in the history of plastic surgery. Initially it was not for enhancement at all, only for repairing injured soldiers with gruesome facial wounds. When surgery started being done for purely cosmetic reasons, most people thought it was weird or downright wrong. But gradually it gained acceptance and now it’s commonplace.

People have discovered that some of the drugs used to treat neuropsychiatric disorders also affect normal healthy individuals. The most common example of this is the use of ADHD meds by college students. These students report that the meds improve their attention and memory, helping them study more effectively. Drugs used to treat depression and Alzheimer’s disease also seem to have subtle positive effects on mood and cognition in healthy individuals, although their side effects usually outweigh their enhancing effect, so they are not popular for enhancement.  Down the line we may see nondrug treatments used for brain enhancement, for example, transcranial magnetic stimulation and transcranial direct current stimulation. These methods involve different ways of creating weak electrical currents in the brain, and laboratory research has shown that they can enhance some abilities in normal people.

On pros and cons. . . .  The first con that comes to my mind is health risk. These drugs and devices are not tested by normal subjects using them long-term. In particular, most ADHD meds carry a certain risk for addiction, especially when not used for treating ADHD. But there are lots of other risks and worries associated with brain enhancement, including fairness – does it give an unfair edge? Will only the wealthy get to use them? And the risk that people will start to feel compelled to enhance, once a sizable portion of their fellow students or workers are doing so. As for pros, well, assuming it is safe, who wouldn’t want to be smarter, happier, and so on? And wouldn’t it be better for society as a whole to have everyone solving problems more effectively and walking around in a good mood? What if we could enhance compassion? It’s not necessarily all about enhancing oneself at the expense of other people’s positions.

KAF: What is the greatest mystery that neuroscientists have yet to solve?

MJF: Consciousness. I think that would be every neuroscientist’s answer. Where different neuroscientists diverge is on the question of whether we’ll ever be able to solve it. Some are working on the problem with a good deal of optimism, and seem to be saying, “Just give us time, we’re getting there but it may take a while.” In that camp I would put the late Francis Crick.  Others are less optimistic. I wouldn’t say I am 100 percent convinced that we’ll never solve it, but I don’t see even the smallest glimmerings of a start. I fully expect to live and die never understanding how the heck this conscious mind thing that is me is related to the material world.

KAF: What do you think the most exciting area of neuroscience research will be in the next twenty years? Fifty years?

MJF: I think there are so many different fronts in neuroscience where exciting progress is being made, but one place where the learning curve seems incredibly steep is the development of neural prosthetics and brain-machine interfaces. It would not surprise me if we have some fairly significant new ways of altering brain function in humans twenty years from now, using deep brain stimulation and if, in fifty years, we have chips that augment natural brain function and allow us to enhance in ways very different from drugs.

KAF: Thank you so much for your time.

MJF: It was a pleasure Karen. Thanks for the fun and stimulating questions.