Neuroethics最新文献

{"title":"The Enduring Promise of Personalising Patient Preference Prediction.","authors":"Brian D Earp, Sebastian Porsdam Mann, Tessa van Veenendaal, Jemima Allen, Sabine Salloch, Karin Jongsma, Matthias Braun, Walter Sinnott-Armstrong, Julian Savulescu, David Wendler, Annette Rid","doi":"10.1007/s12152-026-09635-7","DOIUrl":"10.1007/s12152-026-09635-7","url":null,"abstract":"<p><p>The challenge of making healthcare decisions for incapacitated patients continues to confront stakeholders worldwide. Annette Rid and David Wendler proposed a Patient Preference Predictor (P3) that uses population-level data to infer an incapacitated patient's likely treatment choices, with the aim of aligning care with the values and preferences they held when last autonomous. Some objectors claimed this would fail to respect patients' (former) autonomy because the basis for prediction would not be specific to the individual (e.g., based on data reflecting their own specific reasons for preferring one course of action over another). In response, we proposed a 'Personalised Patient Preference Predictor' (P4) that would harness the predictive capacities of personalised large language models (LLMs) fine-tuned on individual-level data of various kinds. The envisioned P4, if realized, would be akin to a 'digital psychological twin' or AI simulation of the patient that would encode their unique preferences and values to enable an individualised prediction of their likely treatment preferences. The P4, in turn, has been criticised on various grounds: philosophical, practical, and ethical. Here, we comprehensively evaluate the concerns of our critics based on all known published critiques as of the time of writing. While acknowledging the weight of some of these concerns, we argue that they do not entail that a P4 should not be developed. Rather, the concerns point to areas where thoughtful design choices, responsible regulation, and further philosophical reflection are needed to steer the proposal in a positive direction.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"19 1","pages":"17"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Life Models and Transformative Choices: Could AI Simulations of Individual Minds (AI SIMs) Help us Make Important Life Decisions More Rationally and Authentically?","authors":"Christopher Register, Sebastian Porsdam Mann, Cristina Voinea, Julian Koplin, Julian Savulescu, Brian D Earp","doi":"10.1007/s12152-026-09662-4","DOIUrl":"10.1007/s12152-026-09662-4","url":null,"abstract":"<p><p>The article advances the idea of \"digital life models\" to assist with difficult personal decisions, including those that can change an individual in profound ways. We propose that if personalized AI simulations can model how an individual's life might unfold under different conditions, this could help the individual better understand the likelihoods and expected subjective value of these possible outcomes. It remains to be seen whether these digital life models are technically feasible, given fundamental challenges in modeling psychological complexity, person-environment interactions, and value change. Ethical concerns include data privacy, cultural bias, and the risk of improperly shaping user decisions. Acknowledging these limitations, we argue that digital life models, if successfully developed, could in principle enhance rational and authentic decision-making in the face of potentially transformative change.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"19 2","pages":"42"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precautionary Principle and Post-Mortem Brain Resuscitation.","authors":"Brandon Long, David Resnik","doi":"10.1007/s12152-025-09605-5","DOIUrl":"10.1007/s12152-025-09605-5","url":null,"abstract":"<p><p>Recent advancements in brain research have drastically increased the need for serious ethical consideration. <i>Postmortem</i> brain research has taken a significant step in the development of BrainEx. The technology can metabolically resuscitate pig brains from pigs that were \"clinically dead\" for hours. Ethical discourse around organoids ranges from being overly cautious and sensational to highly permissive and skeptical of even minimal consciousness emerging in such a model. Some of these criticisms are allayed in postmortem brains. As such, postmortem brain research presents philosophers and policymakers with a higher risk model of being conscious. The outcome of researchers unknowingly subjecting postmortem brains to negative mental states through research will be termed brain-in-a-vat-world. We will provide some motivation to believe this is a reasonable outcome of proceeding with postmortem brain research. As such, we propose applying the PP to all postmortem brain research. These precautions go beyond previous precautions of brain activity monitoring and the willingness to administer anesthetics to the brains should they appear awake. These precautions aim to avoid potential negative mental states. Such precautions reasonably mitigate the risk of postmortem brain research causing suffering. We recommend several practical precautions. First, anesthetics may prevent any conscious experience at all, cingulotomies prevent painful experiences, and the administration of opioids may prevent boredom or isolation. IRBs should work to determine how these precautions interact with experimental outcomes and how to balance the risk of side effects in light of the experimentation period. The upshot of the article is such PP applications avoid overapplication of the PP, which has occurred in the brain organoid literature. Further, the PP, we argue, provides better guidance to precautionary policy than decision theory, given the difficulties with applying decision theory in medical ethics.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ethics of Set and Setting in Psychedelic Psychotherapy.","authors":"Kyle Patch, William R Smith","doi":"10.1007/s12152-025-09600-w","DOIUrl":"10.1007/s12152-025-09600-w","url":null,"abstract":"","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Privacy in perspective: research participants' priorities and concerns related to sharing data generated in human neuroscience studies.","authors":"Christi J Guerrini, Jill O Robinson, Norah L Crossnohere, Mary A Majumder, Kathryn Maxson Jones, Whitney Bash Brooks, Sameer A Sheth, Amy L McGuire","doi":"10.1007/s12152-025-09609-1","DOIUrl":"10.1007/s12152-025-09609-1","url":null,"abstract":"<p><p>The societal benefits from sharing and reusing data collected in human neuroscience studies are widely appreciated. However, there are persistent barriers to data sharing as well as privacy concerns related to unauthorized access, misuse, and reidentification of deidentified data. Thus far, few studies have been conducted with neuroscience research participants to understand their data sharing priorities and concerns. We conducted a survey utilizing an experimental design with N=52 participants in neuroscience studies funded by the U.S. National Institutes of Health representing diverse neurotechnologies and health conditions. Respondents prioritized sharing practices that maximize reuse of data to benefit patients and reduce the possibility of misuse of shared data. Most believed that both advancing research as quickly as possible and protecting their privacy are important. However, when forced to choose between these objectives, two-thirds of respondents believed that advancing research is most important. Reflecting on specific secondary use scenarios, the largest proportion of respondents were concerned about the possibility their shared brain data might be used to discriminate against them. On balance, respondents were less concerned about sharing their health information, including their brain imaging results, than sharing their online, spending, and location histories. The results affirm that data sharing with secondary researchers with the goal of helping patients by advancing research should remain a top priority and provide empirical support for legislation to prevent harms from misuse of sensitive personal data.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 2","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The \"wheels that keep me goin'\": invisible forms of support for brain pioneers.","authors":"Andrew Ivan Brown, Katherine E MacDuffie, Sara Goering, Eran Klein","doi":"10.1007/s12152-025-09593-6","DOIUrl":"10.1007/s12152-025-09593-6","url":null,"abstract":"<p><p>Research participants in long-term, first-in-human trials of implantable neural devices (i.e., brain pioneers) are critical to the success of the emerging field of neurotechnology. How these participants fare in studies can make or break a research program. Yet, their ability to enroll, participate, and seamlessly exit studies relies on both the support of family/caregivers and care from researchers that is often hidden from view. The present study offers an initial exploration of the different kinds of support that play a role in neural device trials from the perspectives of brain pioneers and their support partners (spouses, paid caregivers, parents, etc.). Using a mixed methods approach (semi-structured, open-ended interviews and a survey) with interpretive grounded theory, we present narratives from a study of six pioneers -- four in brain-computer interface (BCI) trials, and two in deep brain stimulation (DBS) trials -- and five support partners, about their experiences of being supported and supporting participants in implantable neural device studies. Our findings indicate the substantial amount of work involved on the part of pioneers - and some support partners - to make these studies successful. A central finding of the study is that non-logistical forms of support - social, emotional, and epistemic support - play a role, alongside more widely acknowledged forms of support, such as transportation and physical and clinical care. We argue that developing a better understanding of the kinds of support that enable neurotechnology studies to go well can help bridge the gap between abstract ethical principles of caring for subjects and on-the-ground practice.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enslaving Minds: On Freedom of Thought and the Exploitation of Mental Vulnerabilities.","authors":"Sjors Ligthart","doi":"10.1007/s12152-025-09620-6","DOIUrl":"10.1007/s12152-025-09620-6","url":null,"abstract":"<p><p>One central principle often derived from the right to freedom of thought (RFoT) is that persons' inner thoughts shall not be impermissibly altered. Since a clear definition of 'impermissible alteration' of thought is lacking, the meaning and scope of this principle are largely uncertain. Scholars are now exploring how to operationalise the notion of 'impermissible alteration' of thought. For this, some have appealed to the concept of 'manipulation', proposing that mind interventions plausibly infringe the RFoT if they are manipulative. This paper argues that the appeal to manipulation is unpersuasive. It explores the potential of the distinct notion of exploitation, which is, unlike manipulation, an international legal concept that underpins absolute prohibitions in human rights law.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 3","pages":"48"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12594718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145483566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conflicting Interests and New Frontiers: A Role for Virtue Ethics in Cutting Edge Brain Research with Humans.","authors":"Ally Peabody Smith, Lilyana Levy, Colleen Hanson, Nader Pouratian, Ashley Feinsinger","doi":"10.1007/s12152-025-09618-0","DOIUrl":"10.1007/s12152-025-09618-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;One of the central goals of recent neuroethics research is to understand the ethical implications that rapidly evolving neuroscientific discoveries and technologies may have for research participants, patients, and society. From adequate informed consent and post-trial obligations to impacts on agency and disability justice, neuroethicists have argued that the unique clinical, investigative, and financial context of these advances raises distinct and urgent ethical challenges. While much of the ethics work has been advanced through soliciting the perspectives of patients, participants, and the broader public, comparatively little work has explored the experiences of researchers who lead these studies, what ethical issues they face, and how they navigate them. Compared to other parties, investigators are uniquely situated with respect to both their agency and experience. They are the only stakeholders who experience ethical issues before, during, and after a study, and who interact with industry, universities, federal agencies, funders, IRBs, medical centers, ethicists, patients, participants, and caregivers. They are also in a position to determine, with relative authority, the designs of their studies and the solutions to ethical issues as they arise. Understanding researcher experiences is thus a critical part of recognizing, navigating, and mitigating the ethical issues that arise in cutting edge brain research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a qualitative study with 14 NIH BRAIN Initiative-funded investigators, whose research spans 11 institutions and which involves various kinds of invasive brain research with humans. Interviewees were asked about their experiences conducting research and responding to ethical challenges, navigating academic and commercial institutions, interacting with patients, participants, and other researchers, and engaging with neuroethicists. Interviews were coded and analyzed utilizing an inductive and semantic reflexive thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analyses of interviews yielded two main themes: (i) the difficulty of navigating complex conflicts of interest and (ii) the need for collaboration, community, and participation in neuroethics deliberation. Researchers describe facing multiple underappreciated structural and interpersonal conflicts of interest (including those from research funding, team structure, data collection and sharing obligations, commercialization, innovation, and the boundaries between research and care), as well as the need for increased engagement with participants, ethicists, and each other.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Drawing on this data, we argue that navigating ethical issues in cutting edge brain research requires a shift from focusing on promoting ethical guidelines to also promoting neuroethical competencies. More specifically, we argue that integrating the philosophical discipline of virtue ethics-which focuses","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 3","pages":"47"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Explant or not to Explant Neural Implants: an Empirical Study into Deliberations of Dutch Research Ethics Committees.","authors":"Katherine Bassil, Karin Jongsma","doi":"10.1007/s12152-025-09619-z","DOIUrl":"10.1007/s12152-025-09619-z","url":null,"abstract":"<p><p>Neural implants such as brain-computer interfaces and spinal cord stimulation offer therapeutic prospects for people with neurological and psychiatric disorders. As neural devices are increasingly tested in clinical research, the decision to explant requires carefully weighing both known and unknown medical and psychological risks, necessitating a thorough evaluation of the benefits and risks of each available option. Research Ethics Committees (RECs) play an important role in assessing research protocols and determining the conditions under which neural implants should be explanted, yet little is understood about how RECs make these decisions. To better understand the role of RECs in explantation decisions of neural implants, we approached REC secretaries within the Netherlands via email, with a list of open-ended questions of which the explantation of neural devices, on informed consent and post-trial care and responsibilities, and psychological harm associated with such trials. The findings highlight the differential technology-specific safety assessments conducted for different types of neural devices. Variability was observed in plans regarding clinical follow-up, post-trial access, and explantation options. While RECs emphasized clear participant information on device maintenance and longevity, the timing of this disclosure varied. Additionally, the psychological impact of explantation was rarely addressed in REC assessments, indicating a gap in ethical oversight. These results shed light on some remaining gaps and suggest the need for improvement in achieving more consistent and comprehensive evaluations of neural device clinical trials, particularly regarding explantation and post-trial access.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12152-025-09619-z.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 3","pages":"45"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12513904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Treatment Worse than the Disease?: Key Stakeholders' Views about the Use of Psychiatric Electroceutical Interventions for Treatment-Resistant Depression.","authors":"Laura Y Cabrera, Robyn Bluhm, Aaron M McCright, Eric D Achtyes","doi":"10.1007/s12152-024-09573-2","DOIUrl":"10.1007/s12152-024-09573-2","url":null,"abstract":"<p><p>Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat psychiatric conditions. For depression therapy, PEIs include both approved treatment modalities, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS), and experimental neurotechnologies, such as deep brain stimulation (DBS) and adaptive brain implants (ABIs). We present results from a survey-based experiment in which members of four relevant stakeholder groups (psychiatrists, patients with depression, caregivers of adults with depression, and the general public) assessed whether treatment with one of four PEIs (ECT, rTMS, DBS, or ABIs) was better or worse than living with treatment-resistant depression (TRD) and then provided a narrative explanation for their assessment. Overall, the prevalence of many narrative themes differed substantially by stakeholder group-with psychiatrists typically offering different reasons for their assessment than non-clinicians-but much less so by PEI modality. A large majority of all participants viewed their assigned PEI as better than living with TRD, with their reasons being a mix of positive views about the treatment and negative views about TRD. The minority of all participants who viewed their assigned PEI as worse than living with TRD tended to express negative affect toward it as well as emphasize its riskiness, negative side effects, and, to a lesser extent, its invasiveness. The richness of these narrative explanations enabled us to put in context and add depth to key patterns seen in recent survey-based research on PEIs.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at 10.1007/s12152-024-09573-2.</p>","PeriodicalId":49255,"journal":{"name":"Neuroethics","volume":"18 1","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}