Image: Brain scans
Brain imaging found differences between activity patterns for women who were not alcoholics, at left, and alcohol-dependent women, at right. Could imagery be used to identify alcoholics?
By Alan Boyle Science editor
msnbc.com

June 17, 2002 - What is it that makes you “you”? How much of that can be altered before you become someone else? Can your identity be passed on to another generation? Should it? These are the questions that buzz around human cloning — but ethicists say the issues could come to a head more quickly in the burgeoning realm of brain research.

While researchers have been racing to decode the human genome and policy-makers have been fretting over the first cloned human embryo, the low-profile flow of discoveries about the brain has turned into a flood.

“Cognitive neuroscience and neuroimaging have taken enormous strides very quickly, without a multinational, multibillion-dollar ‘human neuron project,’” said Paul Root Wolpe, a senior fellow at the University of Pennsylvania’s Center for Bioethics. “So much of the attention people are putting into genetics would be better put into neuroethics.”

Wolpe already may be getting his wish: Cover stories have been written about the promise and perils of brain science. Even “Minority Report,” one of the summer’s science-fiction blockbusters, plays off research into how brain structure is linked to behavior.

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Functional brain imaging may not be able to pinpoint future criminals, but some believe it could predict who will be prone to future drug abuse, who might be telling a lie, who could suffer from diseases such as Alzheimer’s or multiple sclerosis.

Last month’s flap over the ultimate fate of baseball great Ted Williams highlighted the cryonic dream of reviving a brain from the deep-freeze — and perhaps uploading the mind into a computer or a clone. Although that’s still deep within the realm of science fiction, it’s not so far-fetched to imagine injecting new cells into the brain to fix a failing mind or a paralyzed limb.

Even today, you can take drugs to change your mood, increase concentration or enhance memory.

What's wrong with that?
The flip side is that a future employer could conceivably use brain imaging to decide whether you rate a promotion. Future drugs could be used to keep nonconformists under control. Future brain implants could leave you wondering how much of “you” is really left.

Art Caplan, the Center for Bioethics’ director and an MSNBC.com columnist, shares Wolpe’s view that brain research could pose more pressing ethical concerns than genetic research — since neuroscience could provide quicker, more efficient methods for modifying humans.

“If you want to enhance, improve or alter behavior, I think you’re better off trying to do it by brain engineering than by gene engineering,” Caplan said.

Neuroscience also plays a big part in the debate over stem-cell research, since some of the field’s brightest promises of such research have to do with repairing the nervous system and even enhancing healthy brains.

Compared with the fields of genetic and reproductive ethics, neuroethics is still new territory, Caplan said. A series of seminars sponsored by the Dana Foundation is bringing together clinicians, researchers and philosophers to make recommendations on the key ethical issues in brain medicine. A draft report is due to be circulated by summer’s end, said Barbara Koenig, executive director of Stanford University’s Center for Biomedical Ethics.

“Some of the issues in the neurosciences are going to present real clinical issues and practical research issues immediately,” said Koenig, who served as a co-chair for a neuroethics conference at Stanford in May.

Here’s a look at some of the leading issues:

This is your future brain on drugs
Brain research is giving rise to a rapidly growing class of drugs known as psychopharmaceuticals — such as Prozac to counter depression, or Ampalex to treat schizophrenia or memory deficits.

“There are already a lot of psychopharmaceuticals which can alter personality and perhaps other elements of humanness,” Koenig said. Where do you draw the line between fixing brain chemistry that’s out of whack and tweaking someone’s state of mind too much? What if a healthy person wants to take psychopharmaceuticals to ace an exam or impress a mate?

“We are going to have to make decisions at some point about whether we are going to regulate enhancement drugs. ... Are doctors simply going to become people who ask patients what prescriptions they want?” Wolpe said.

Images that get inside your head
Wolpe also believes brain scans will have to be more closely regulated. “People getting neuroimaging scans for one reason or another may have something that shows they were a former drug addict,” he said. How should that information be shared? And if scanning technologies become cheaper and more refined, how widely should they be used?

“Are we going to allow employers and schools (to use them) as lie detectors or try to find abnormalities in the brain?” Wolpe asked.

Ethicists also worry that neuroimaging may develop into as a 21st-century brand of phrenological quackery.

“You suddenly say, ‘Oh, we take a picture and it’s green, and this is associated with X, Y or Z behavior.’ ... Just the idea that we’re thinking we can, in this very reductionist way, imagine how someone will behave seems to me to be extremely naive and somewhat dangerous,” Koenig said.

Who am I this time?
Patients are already receiving bionic implants to fix broken senses — and future neural implants could restore control over paralyzed limbs. Recent experiments with wired monkeys have demonstrated the possibilities.

Brain cell transplants and brain microsurgery, however, raise deeper questions.

“Little manipulations where you’re making a chemical that your brain needs to secrete might turn out to be fine,” Caplan said. “But other dreams about repairing the brain start to move from the hormonal to the stored memory pattern. ... Anything that involves changing more than a minimal amount of the circuitry comes close to changing ‘you.’”

Wolpe said such operations touch on “the issue of who we are ... the idea that we are, in some sense, our brains.”

Consider some of the far-out ideas that already have become reality: injecting human neural stem cells into rats ... wiring rat brains to respond to remote commands ... monkey brain implants that move mechanical arms 600 miles away ... even monkey head transplants that today seem as shocking as the prospect of a human clone.

“The current technology is about as far out as you can get,” Wolpe says. “How much further ‘far out’ do we want to get?”

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