On Not Reinventing the Wheel: Need We See the Governance of Research in Neuroscience as Somehow Special?

Introduction

The impetus to this article was the ongoing development of ethical research governance in Singapore. This has been a preoccupation of the Bioethics Advisory Committee (BAC), Singapore, since its inception in 2000.¹ The BAC is, at the time of writing, actively considering the implications of new technologies for neuroscience research within an established framework of ethics governance in Singapore, and what if any consequential changes to this framework might be needed. This therefore seems an opportune moment to consider some potential ethical issues in neuroscience research. This article acknowledges and briefly describes the ethical framework that the BAC fuses, but is written independently and not as representing the BAC or its position on these issues.

Neuroscience attracts interest because the brain is the organ of the mind and the seat of consciousness. Accepting, for the moment, the inherent dualism behind this formulation, together with a naturalistic implication that the undisturbed brain somehow reflects our true selves, it seems that anything that might seem to risk or alter the brain, risks altering ourselves. Whether or not this accurately captures an important concern, it will do as the starting point for an exploration of whether some kind of neuroscience exceptionalism is justified. By neuroscience exceptionalism, I mean simply the proposition that neuroscience, by virtue of its subject matter, requires special or different treatment when it comes to the ethical principles that are entailed in good ethics governance, or their application.

The burden of the argument to be presented is that the general principles underlying ethical governance of biomedical research in general will, if applied sensibly, provide most of the necessary protection for participants when considering basic or clinical research or experimental treatments. There are, however, exceptions, which may require an additional principle.

I first briefly outline the principles I am appealing to, and then consider two questions:

1. 1. Does neuroscience research raise issues not already addressed within the existing governance framework?

2. 2. Does neuroscience-based human enhancement raise such issues?

   I am excluding research involving laboratory procedures applied to cells or tissue, and research dealing exclusively with the peripheral nervous system or the autonomic nervous system. The focus is work impacting the central nervous system (CNS), usually research with clinical applications, or where a treatment is experimental in nature.

Ethical Principles

Listed below are the five principles guiding the BAC and on which this article is predicated:²

1. 1. Respect for individuals. This entails:

   1. a. Beneficence and non-maleficence;

   2. b. Respect for the autonomy and liberty of persons, where autonomy means respecting the right of persons to make their own decisions without being coerced, misled, or kept in ignorance;

   3. c. Respect for the privacy and dignity of the person;

   4. d. Respect for cultural diversity and beliefs.

2. 2. Solidarity — supporting the idea of public good. Respect for the individual does not trump all other considerations, one of which is the interest of the wider public. This was formerly articulated by the BAC as a principle of reciprocity.³

3. 3. Proportionality — regulate in proportion to risk;

4. 4. Justice — fairness and equality, without exploitation through research of one group, class or society for the benefit of another, and with the benefits of research available generally and not exclusively, on whatever are agreed principles of equity in clinical services or practical benefits; and

5. 5. Sustainability — there should be no future jeopardy, especially to future generations, accruing from research activities; most often used as a justification for limiting efforts to alter the human genome.

These principles strongly reinforce the expectation that research will not be conducted without the informed consent of the parties involved, where consent is not a matter of the mere provision of information, but a matter of participant understanding.⁴ They have also brought the well-being of research participants to the fore, so that researchers and their institutions are seen as having certain obligations, in respect of the discovery of clinically significant conditions and to minimise research hazard generally.

Does Neuroscience Research Raise Issues Not Adequately Regulated within This Framework?

One might think, as the...