Neuroscience research on the addictions: A prospectus for future ethical and policy analysis

Abstract

The increasing evidence that many addictive phenomena have a genetic and neurobiological basis promises improvements in societal responses to addiction that raise important ethical and social policy issues. One of the major potential benefits of such research is improved treatment of drug addiction, but in order to do the research required to realize this promise, it will be necessary to address ethical doubts raised about the capacity of addicted persons to give free and informed consent to participate in studies that involve the administration of drugs of dependence. Neuroscience research on addiction promises to transform the long running debate between moral and medical models of addiction by providing a detailed causal explanation of addiction in terms of brain processes. We must avoid causal models of addiction being misinterpreted as supporting simple-minded social policies, e.g., that we identify the minority of the community that is genetically and biologically vulnerable to addiction and hence can neglect social policy options for reducing addiction, including drug control policies. Causal accounts of addiction supplied by neuroscience and genetic research may also be seen to warrant the use of pharmacotherapies and drug vaccines under legal coercion. Neuroscientists also need to anticipate the ethical issues that may arise if the knowledge that they produce delivers interventions that enhance human cognitive and other capacities. Advances in neuroimaging that enable us to identify ''addicts'' or predict future risk of addiction will raise concerns about invasion of privacy, third-party use of neuroimaging data, the powers of courts to coerce defendants to undergo such tests, and consumer protection against the overinterpretation of test results. Given the strong public and media interest in the results of their research, neuroscientists and geneticists have a moral obligation, and a professional interest, to minimize popular misunderstandings of their work in the media that may rebound to its detriment.

Brain Imaging

“…Many researchers and scholars have voiced concerns that simplistic understanding of such neuroimaging modalities may increase the risk for misuse and the possibility of the abuse of consumers who are lured by the high-tech profile of the technology (Farah and Wolpe 2004;Gura 2005;Hinton 2002;Kulynych 2002;Stufflebaum and Bechtel 1997). Our study, therefore, further grounds repeated calls for increased neuroscientist involvement in the popularization of research findings (Bruer 1998;DiPietro 2000;Hall, Carter, and Morley 2004;Hinton 2002;Kulynych 2002;Racine, Bar-Ilan, and Illes 2005;Rose 2003), as well as particular attention to the epistemological issues of neuroimaging in public communication Illes, Racine, and Kirschen 2005).…”

Drug-Induced Impulse Control Disorders: A Prospectus for Neuroethical Analysis

“…This neurobiological understanding may also assist in the development of more effective therapeutic interventions, whether they be pharmacological, psychological or social, or some combination of these. However, as we have argued elsewhere, a neurobiologically reductive understanding of addiction may have significant adverse ethical and public policy consequences [77][78][79].…”

Avoiding potential misuses of addiction brain science

“…Some social scientists and ethicists [7,13] have pointed to a number of potentially less welcome social consequences of the 'brain disease' model of addiction. Simplistic interpretations of this model of addiction have been used to justify heroic treatment interventions in the brain's function, such as ultra-rapid opiate detoxification [14] and, recently, neurosurgery for heroin dependence [15,16].…”

“…Simplistic interpretations of this model of addiction have been used to justify heroic treatment interventions in the brain's function, such as ultra-rapid opiate detoxification [14] and, recently, neurosurgery for heroin dependence [15,16]. If addicts suffer from a brain disease, then it may also be argued that they need to be coerced legally into treatment because they are incapable of acting in their own best interests [13]. Universal childhood vaccination against drugs could come to be seen as a morally justified 'public health' measure to prevent an epidemic of 'chronic brain disease' [8].…”