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Neuroethics
Agency in the Age of Brain Science
JOSHUA MAY
Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and certain other countries.
Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America.
© Oxford University Press 2023
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by license, or under terms agreed with the appropriate reproduction rights organization. Inquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above.
You must not circulate this work in any other form and you must impose this same condition on any acquirer.
Library of Congress Cataloging-in-Publication Data
Names: May, Joshua, author.
Title: Neuroethics : agency in the age of brain science / Joshua May. Description: New York, NY : Oxford University Press, [2023] | Includes bibliographical references and index.
Identifers: LCCN 2023006178 (print) | LCCN 2023006179 (ebook) | ISBN 9780197648094 (paperback) | ISBN 9780197648087 (hardback) | ISBN 9780197648124 (ebook) | ISBN 9780197648117 (epub)
Subjects: LCSH: Neurosciences—Moral and ethical aspects. | Agent (Philosophy)
Classifcation: LCC RC343 .M395 2023 (print) | LCC RC343 (ebook) | DDC 612.8—dc23/eng/20230315
LC record available at https://lccn.loc.gov/2023006178
LC ebook record available at https://lccn.loc.gov/2023006179
DOI: 10.1093/oso/9780197648087.001.0001
Paperback printed by Marquis Book Printing, Canada Hardback printed by Bridgeport National Bindery, Inc., United States of America
To my parents and my students, who have shaped my brain for the better.
I note the obvious diferences between each sort and type, but we are more alike, my friends, than we are unalike.
Maya Angelou from the poem “Te Human Family”
–
PART II. A UTONOMY
6.
5.1
5.3
5.4
5.5
PART III. CARE
8.
8.1
PART IV. CH ARACTER
PART V. JUS TICE
PART VI. C ONCLUSION
4.1
Preface
Immanuel Kant famously proclaimed: “Two things fll the mind with ever-increasing wonder and awe . . . the starry heavens above me and the moral law within me.” I would add the three-pound organ between my ears. It’s no understatement to say we’re in the age of brain science. We’ve come so far since the days of lobotomies and phrenology, and yet we remain largely ignorant of how these billions of neurons generate the mind. Since the brain is the seat of the self, this new frontier brings forth new ethical conundrums and forces us to reconsider the conception of ourselves as rational, virtuous creatures with free will.
As with all frontiers, there is the risk of excessive zeal and overreach. Unlocking the mysteries of the brain and deploying novel neurotechnologies is both alluring and scary. Many scientists and ethicists are led to speculate about and oversell the prospects or perils of the science. We’re sometimes told that advances in neurobiology reveal that free will is a farce but that these same advances also have the power to make us superhuman. Ethical alarm bells ring with urgency.
My aim in this book is to take the brain science seriously while carefully and soberly scrutinizing its ethical concerns and implications. Te “nuanced neuroethics” that emerges is modest, not alarmist, yet we’ll see that our present understanding of the human brain does force us to see our minds as less conscious and reliable— though more diverse and fexible—than we might otherwise think. Tis balanced conception of human agency has direct implications for how we address the ethical concerns raised by this new frontier. Ultimately, I hope a more nuanced approach to the entire feld helps us appreciate the abundant forms of agency made possible by the human brain.
Ambitions
Te text aims to be a contribution, as well as an introduction, to the literature. We will not merely raise tantalizing ethical questions, which is all too common in neuroethics, but also attempt to answer them. So the tour of this burgeoning feld will be a rather opinionated one. Similar to the book’s goal of dismantling dubious divisions between the neurologically typical and atypical, the book itself openly challenges the distinction between a research monograph and a textbook.
For years, I have taught an undergraduate neuroethics course at the University of Alabama at Birmigham (a sample syllabus is available on my website, joshdmay.com). It’s the sort of class that cries out for a textbook that’s accessible to both neuroscience and philosophy majors. Neuroscience is an increasingly popular major on college campuses, and these students deserve a philosophically rich discussion of the ethical issues, informed by the latest scientifc evidence and its limitations.
For the philosophy majors, in my experience, neuroethics serves as an excellent special topics course, even a capstone for the major. It tackles a range of cutting-edge philosophical problems that span not just ethical issues (such as autonomy, justice, and virtue) but also other subfelds, such as the metaphysics of mind (free will, personal identity, the mind-body problem) and epistemology, especially the philosophy of science (drawing sound scientifc inferences, understanding the role of values in science). Te present text in particular draws on recent insights from metaphysics (transformative experience, the moral self), philosophy of science (medical nihilism, reverse inference), and disability advocacy (neurodiversity). Tus, neuroethics requires philosophy students to apply their broad philosophical knowledge to contemporary problems.
Students will fnd that, although this book introduces neuroethics, it is not introductory. Te feld is relatively new, situated at the cutting edge of philosophical and scientifc debates. Te many controversial issues require readers to dig into both data and the bread and butter of philosophy: arguments. Alongside this comparatively dry main course, however, will be rich stories and savory science (with an
occasional sip of word play as a digestif). Te book also employs some handy expository tactics from the sciences, such as fgures and tables. I hope readers will see the value in clearly representing, breaking down, and analyzing both scientifc evidence and arguments with premises.
Te style of the book assumes readers are comfortable with philosophical writing and argumentation. Moreover, since I aim to point readers to the relevant literatures, and situate my own views well within them, citations are not kept to a minimum. I’ve tried to write the book so that it’s suitable for adoption in classes that, like my own neuroethics course, are comprised of students who already have some philosophy under their belts. Nevertheless, the topics may be enticing and palatable enough for a wide range of students and scholars to digest.
Readers should take home the message that philosophy and neuroscience help one another. I hope neuroscientists will see that philosophical analysis helps us to clarify murky debates, draw important distinctions, and clearly construct and evaluate arguments. However, as the neuroscientists might be quick to point out, philosophical analysis must be properly informed by the science.
Philosophers are ofen dubious of the relevance of neuroscience to philosophical questions. Sure, philosophers from antiquity have cared about how the human mind works, but shouldn’t we just look directly to the brain’s sofware (the feld of psychology) rather than its hardware (neuroscience)? Troughout this book we’ll see that neurobiology reveals psychological functions and limits, especially in cases of brain damage. Direct interventions on the brain’s hardware also yield novel treatments that raise important ethical questions. And studying the brain directly can sometimes provide a more direct line to the mind that bypasses the mouth, which is prone to rationalizations or outright lies. Another balm to the philosopher’s skepticism about brain science is the recognition that it’s not all about brain imaging. Neuroscience includes psychopathology, brain damage, neurochemistry, and brain stimulation technologies. When the evidence about the brain’s hardware converges with psychological science, philosophical analysis, and other felds of inquiry, we start to gain a handle on the mysteries of the mind and the ethical issues they raise.
Format
Te main chapters share some recurring features. Each kicks of with a case study to help ground abstract issues in the lives of real people. Neuroethics ofen inspires speculations about moral problems of a distant future when humans can skillfully manipulate their brains with great precision, like cyborgs in a sci-f thriller. Against this trend, I stick to case studies from the present or recent past in order to avoid alarmism and undue attention to problems the human species may never live to face.
I have also compiled a companion website (visit joshdmay.com). Tere readers will fnd discussion questions for each chapter, which can help spark dialogue in a class or reading group.
Te grouping of chapters is a bit unorthodox. Discussions of neuroethics ofen divide its topics into the more theoretical and the more practical issues (the “neuroscience of ethics” and the “ethics of neuroscience”). I have opted instead to switch back and forth between the two sorts of questions in neuroethics, for several reasons. First, the divide between the theoretical and practical is ofen blurry and boundaries are arbitrary. Second, the answers to some questions in one domain rely on answers from another. Te practical question of whether it’s ethical to alter our brains to become better people, for instance, depends on a more theoretical understanding of how moral cognition works in the brain. Finally, interweaving the topics helps shake things up and minimize the fatigue that comes from repetition.
Troughout the book, I discuss other theorists’ answers to these questions, but I also develop my own take. I will serve as both a tour guide and interlocutor, for this is no ordinary trip through the annals of history but an active debate rife with arguments and ethical implications. If you’re more of a student than a scholar and fnd yourself adamantly disagreeing with my view, congratulate yourself on having a philosophically active mind! Indeed, if you fnd yourself readily agreeing with me on the controversial issues of neuroethics, perhaps you should take pause and reevaluate your tendencies toward credulity. (For those active in these scholarly debates, on the other hand, capitulations are most welcome.)
Acknowledgments
Although I’ve worked across disciplinary boundaries in the past, neuroethics is diferent. Neuroscience is signifcantly larger than psychological science and involves studying the mind at radically diferent levels and angles, from the chemistry of the brain to its gross anatomy, from computational mechanisms to therapeutic interventions. Neuroscience also deploys complicated cutting-edge technologies (such as magnetic resonance imaging and optogenetics) and trades in highly technical terminology (What is a G protein-coupled receptor? What does the ventromedial prefrontal cortex do exactly?). Tis book would not have been possible without some formal training and the time to complete it.
Fortunately, for two weeks in the summer of 2017, I was able to participate in the fantastic Summer Seminars in Neuroscience and Philosophy (SSNAP) at Duke University. Tere, I and about a dozen other fellows learned a great deal about neuroscience from leading researchers while getting hands-on experience with brain anatomy and technologies like transcranial magnetic stimulation. (Tere also may have been some karaoke.) Special thanks to Felipe de Brigard and Walter Sinnott-Armstrong who run those transformative seminars, and to the John Templeton Foundation for funding them. Well beyond these seminars, Walter has been formative throughout my philosophical and neuroscientifc endeavors. Always encouraging and supportive, he has been an inspiring model of how to do interdisciplinary work with philosophical rigor and humor. A true utilitarian, he makes sure work is a joy.
My (joyful) work on this book was also made possible through the support of a paid sabbatical at UAB and then an Academic CrossTraining Fellowship from the John Templeton Foundation (grant #61581). I am ever grateful for this sabbatical-fellowship combo, which freed me from teaching for fve semesters (from 2020 to
2022) so that I could learn much more about brain science and write this book. (Te opinions expressed in this work are mine, of course, and do not necessarily refect the views of the Templeton Foundation.) During this research leave, I attended lab meetings to see how the neuroscience sausage is made, presented at interdisciplinary conferences, talked with neuroscientists and others outside my discipline, and audited the courses required for UAB’s Behavioral Neuroscience PhD. Special thanks go to my academic cross-training mentor Rajesh Kana (Professor of Psychology at the University of Alabama), who is an expert in neuroimaging and social cognition, and all-around a wonderful human being. Rajesh allowed this philosophical gadfy to participate in his weekly lab meetings, and he met regularly with me to discuss philosophy, neuroscience, and the vagaries of a global pandemic.
While working on this manuscript, I received valuable feedback from many philosophers, scientists, lawyers, and clinicians. Tough memory in the human brain is certainly imperfect, my slightly more reliable notes suggest I profted from discussions or correspondence with Kenton Bartlett, Robyn Bluhm, Mary M. Boggiano (Dr. B!), Jonathan Buchwalter (and his 2021 Debate Class at Tuscaloosa County High School), Emily Cornelius, Veljko Dubljevic, Jeremy Fischer, Rachel Fredericks, Frederic Gilbert, Andrea Glenn, Hyemin Han, Julia Haas, Rajesh Kana, Matt King, Victor Kumar, Robin Lester, Neil Levy, Andrew Morgan, Mariko Nakano, Patrick Norton, Greg Pence, Jonathan Pugh, Kristen Sandefer, Katrina Siferd, Walter Sinnott-Armstrong, Michael Sloane (who provided wonderfully detailed comments on every chapter), Macarena Suarez Pellicioni, and Cliford I. Workman. Tank you all. Wholehearted thanks also go to three philosophy majors at UAB—and former Ethics Bowl debate team members—who served as research assistants: Kimberly Chieh, Carly Snidow, and Mohammad Waqas. Tey helped proofread drafs of chapters, come up with discussion questions, and research case studies. I am grateful for their assistance and so very proud of their many achievements at UAB and beyond. Tanks also to my editor, Peter Ohlin, at Oxford University Press who early on was enthusiastic and supportive of this project.
Tree chapters of this book draw from previously published articles of mine. Chapter 4 draws from and expands on “Moral Responsibility
and Mental Illness: A Call for Nuance” published in Neuroethics and co-authored with my friend and colleague Matt King. Our work on that article frst started me down the path to developing a more nuanced approach to neuroethics. Chapter 6 borrows a little from my article “Moral Rationalism on the Brain” published in Mind & Language. Chapter 8 draws from and expands on my paper “Bias in Science: Natural and Social” published in Synthese. My thanks to the publishers (and, in one case, my co-author) for the permission to republish portions of the material here.
Finally, a heartfelt thanks to my wonderful daughter, Juliana. Although too young to provide feedback on more than the cover art for this book, she regularly helped me recharge by being my hiking partner, climbing buddy, sous-chef, and primary source of comic relief.
