Focus Article

Neuroethics
Neil Levy
Neuroethics is a new sub-discipline of philosophy, with two broad focuses. The rst, which has come to be called the ethics of neuroscience, concerns the assessment of ethical issues arising from neuroscience, its practice and its applications; the second, which has come to be called the neuroscience of ethics, concerns the ways in which the sciences of the mind can illuminate longstanding issues within philosophy. Especially in its guise as the neuroscience of ethics, neuroethics cannot sharply be distinguished from the naturalistic trend in philosophy which attempts to bring to bear data to the resolution of philosophical problems. It is distinctive only inasmuch as it is motivated by practical, and especially moral, concerns to a greater degree than empirical philosophy more generally. This article illustrates the practice and typical concerns of neuroethics with two case studies, one from each of its branches. The ethics of neuroscience is illustrated with the issue of cognitive enhancement, and the neuroscience of ethics is illustrated by discussion of free will. With regard to both issues, neuroethicists hope to advance beyond intuition and armchair argument by careful attention to the data emerging from the cognitive sciences. 2012 John Wiley & Sons, Ltd.
How to cite this article:

WIREs Cogn Sci 2012, 3:143151. doi: 10.1002/wcs.1157

INTRODUCTION

euroethics is a relatively new sub-discipline of philosophy. As the name suggests, the central focus of neuroethics is ethical issues arising, directly or indirectly, from neuroscience, but as it is routinely practiced it covers a broader range of issues. Following Roskies,1 we may identify two branches of neuroethics, dubbed by her the ethics of neuroscience and the neuroscience of ethics. As Roskies denes these branches, the ethics of neuroscience concerns ethical issues that arise out of neuroscience (for instance, concern about the application of functional magnetic resonance imagingbased lie detection systems in forensic settings), whereas the neuroscience of ethics concerns the manner in which neuroscience illuminates traditional philosophical questions (for instance, the degree to which we might be required to revise folk or philosophical conceptions of the self in the light of work in cognitive neuroscience). In practice, neuroethicists tend to understand their discipline even more broadly than Roskies suggested, regarding not just neuroscience and its applications as their domain,
Correspondence to: neil.levy@orey.edu.au Florey Neuroscience Institutes, Carlton South, Victoria, Australia

but the cognitive sciences more generally. In this brief article, I will sketch two examples of neuroethical issues, one from each branch dened by Roskies, and outline the manner in which progress on them requires interdisciplinary work, combining expertise from neuroscience, psychology, and philosophy. The rst, the question of the moral permissibility of the use of cognitive enhancing psychopharmaceuticals, is central to what Roskies calls the ethics of neuroscience, whereas the other, the extent to which cognitive science illuminates the question of free will, is an example of the neuroscience of ethics.

COGNITIVE ENHANCEMENT
Many ethicists draw a distinction between two classes of interventions aimed at improving an agents capacities in some domain. Roughly, treatments are aimed at compensating for or undoing the effects of some disease or dysfunction resulting in a failure to perform at species-typical levels, whereas enhancements aim at boosting performance in some domain despite the fact that performance has not been impaired by disease or dysfunction. For many ethicists, the treatment/enhancement distinction marks a morally important difference: between interventions that are
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morally required or at least permissible and those that are not morally required and may even be impermissible. The treatment/enhancement distinction is controversial, with some ethicists denying that there is any useful distinction to be drawn at all,2,3 and other denying that the distinction marks a morally signicant boundary.4,5 Very plausibly, there is a morally signicant difference between improving the functioning of agents whose lives are blighted by disease and those who are already functioning at or above normal levels, and this difference has motivated some to see in the treatment/enhancement distinction a useful heuristic for distinguishing between more and less morally urgent interventions.6 However, the treatment/enhancement distinction is an extremely unreliable heuristic for capturing this moral difference; it seems that insofar as we are motivated by prioritarian considerations, we do better to dispense with it in favor of a more direct measure of moral urgency. Whether, or how, we draw the treatment/ enhancement distinction, there are pressing moral issues raised by interventions that are typically classied as enhancements. Some of the concerns raised are narrowly philosophical in nature. For instance, cognitive science is unlikelydirectly, at any rateto contribute much to the assessment of Michael Sandels7 claim that the enhancement project is an expression of an inappropriate attitude toward the world (although it may be that the concern rests in part on a biologically uninformed notion of how phenotypes develop from genotypes; see Ref 8 for relevant discussion). Where other issues are concerned, however, the moral assessment of a potential enhancement must be sensitive to empirical work on the mechanism and effects of the intervention. Consider one of the most common and important objections to cognitive enhancements: that they threaten to exacerbate social injustice. The worry is simple and intuitive. Most proposed cognitive enhancements are relatively expensive. Some, for example proposed means of enhancing cognitive capacities using transcranial magnetic stimulation9 would be nancially out of reach of all but the very wealthiest individuals; others, for example cognitively enhancing psychopharmaceuticals such as methylphenidate or modanil, could be made available much more cheaply, but seem likely to remain out of reach of the poorest agents (for instance, the many millions who survive on less than U$2 per day, adjusting for purchasing power). As a consequence, cognitive enhancements will be available only to those who are already better off; better off, in particular, in cognitive capacity (birth weight, which reects the nutritional and health status of the mother,
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is correlated with intelligence quotient, even when we restrict our attention to the normal range of weights, thereby excluding children born into extreme poverty10 ). It follows that cognitive enhancements threaten to increase already unacceptably great inequalities, within and between societies. These worries can be reducedalthough not eliminatedby some attention to existing research on the effectiveness of cognitive enhancements. Consider methylphenidate, a psychopharmaceutical widely used in the treatment of attention decit hyperactivity disorder (ADHD). ADHD is a developmental disorder characterized by difculties in maintaining attention and poor impulse control. It is widely believed to be caused (proximally) by a deciency in the neurotransmitter dopamine.11 Methylphenidate, the most widely used psychostimulant for the treatment of ADHD, inhibits the uptake of dopamine, thereby increasing available levels.12 It has been shown to signicantly reduce the symptoms of ADHD in a large proportion of the subjects who take it.13,14 There are widespread reports of methylphenidate being used off-label as a cognitive enhancer, especially by students at high school and college level.15,16 Methylphenidate is relatively cheap; nevertheless it is obviously not so cheap that there are no obstacles to accessing it. Accordingly, insofar as it benets the already better off it raises signicant issues of social justice. However, worries about inequality, though genuine, should be mitigated by an awareness of the effects of methylphenidate. Like at least some other (alleged) cognitive enhancers, there is evidence that methylphenidate has a more dramatic effect on the capacities of those who are functioning at a lower level than on those who are already functioning well. Although methylphenidate improves spatial working memory and sustained attention in healthy adults,17 the better the individual performed on working memory tasks prior to ingestion, the smaller the benet to him or her.18 There is evidence for a similar declining marginal utility of modanil,19 a drug prescribed for the treatment of sleep disorders and allegedly widely used off label as a cognitive enhancer.20 If cognitive enhancers bring a benet to the already better off which is not available to the less well-off, then they raise worries about exacerbating inequalities. However, a balanced assessment of their permissibility must take into account their potential to reduce inequality. There is some evidence that if we can make them available to agents whose level of functioning is below average, we can expect them to benet more than those who are functioning at a higher level, even if the enhancer is made available to everyone. Extrapolating from studies of the effects of removing
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lead from the environment and the subsequent increase in general intelligence, it seems likely that a small rise in cognitive capacities would bring with it great social benets.21 This fact might make it cost-effective for governments to make cognitive enhancements available on a population-wide basis. Furthermore, cognitive enhancers need not be expensive. Even high-tech cognitive enhancers may be relatively accessible. For instance, the apparatus needed for transcranial direct current stimulation (TDCS) is cheap to assemble and indenitely reusable. TDCS has been found to promote mathematical learning.22 Cognitive enhancers may actually be cheaper to provide on a widespread basis than the stimulating environments, skilled parenting and good nutrition and healthcare the patchy provision of which lead to wide gaps in cognitive capacity across socioeconomic classes.2325 Of course, this consideration by itself does not settle the question whether the use of TDCS, or any other cognitive enhancement, is permissible or advisable. It might be that even if we can reduce inequality through the use of such enhancements at lower cost than by alternative methods such as enriching environments, we have good reason to prefer such alternative methods. We might, for instance, have good reason to encourage the use of environmental interventions generally, even if in particular instances there are more efcient alternatives. When the problem is social justice, cognitive enhancers have the potential to be part of the solution, as well as of the problem, but solutions may bring with them further problems. A nal assessment of the advisability of using particular technologies will require contributions from sociology, and perhaps history and anthropology, to understand the likely long-term impacts of such technologies, in addition to work by philosophers and cognitive scientists.

FREE WILL AND NEUROSCIENCE

The traditional philosophical debate concerning free will centers on the question whether determinism is compatible with freedom. This is not a debate to which neuroscience seems likely to contribute, even indirectly, since neuroscience neither depends on nor provides evidence for determinism, not even neural determinism.26 However, neuroscienceand other branches of the cognitive scienceshas opened up new fronts in the free will debate. In this section of this article, I will review just one broad debate triggered by work in cognitive science, centering on the functional role of consciousness. Although there is a great deal of important work on related topics (for instance, on the question whether undermining belief in free will
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leads to a decrease in prosocial behavior; see Ref 27), space limitations require that this work be set aside. The debate over the functional role of consciousness was initially triggered by the pioneering work of Benjamin Libet on the timing of subjects awareness of their intentions to act. Famously, Libet found that agents reported awareness of an intention to act (if indeed the experience reported can be identied with this intention; see Ref 28) was preceded by onset of the readiness potential, electrical activity in the motor cortex that precedes voluntary movement, by about 350 ms.29 Libets experiment has been widely criticized on methodological grounds, but the basic nding has been independently replicated many times in ways that avoid the methodological criticisms (e.g., Refs 30 and 31). The nding that the readiness potential precedes subjective awareness of proximate intention to move seems well-established (it is, in any case, unsurprising; see Ref 32). Libets experiment has been taken to establish the epiphenomenality of consciousness on the following grounds: the onset of the readiness potential apparently precedes the agent having decided on the time of movement. This suggests to some interpreters that there are two independent causal routes to action, one conscious and the other unconscious, with this salient difference between them: only the unconscious route is causally efcacious in causing the action. Many people apparently nd this claim disturbing; indeed, it has widely been taken as evidence for the non-existence of free will.3335 According to this view, free will, if we have it, is a power to act as a result of conscious deliberation; it is this power that Libet demonstrates we lack. Despite the voluminous literature on the work of Libet and his successors investigating readiness potentials and, more recently, lateralized readiness potentials (see Ref 36 for critical review), it is difcult to see how the evidence is supposed to demonstrate the epiphenomenality of consciousness. The fact, if it is a fact, that subjective awareness of the intention to act lags some milliseconds behind the generation of the intention to act does not show that conscious deliberation was not causally efcacious in generating that intention. The brain event represented by the readiness potential might be identical to the agents decision to act; alternatively, it might be the cause of the decision to act. In either case, the fact that it precedes awareness of the decision does not seem to threaten our free will. It is consistent with this evidence that we act for the reasons we take ourselves to have, and that even the timing of our actions is determined by our deliberation.
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If the gap between awareness and the subpersonal processes causing action were much bigger, however, the threat would be genuine: were it to be discovered that these processes had irrevocably settled upon a course of action while we continued to deliberate, the evidence for the epiphenomenality of deliberation would be strong. Soon et al. produced evidence that has been interpreted as demonstrating such a gap between (sub-personal) intention generation and conscious deliberation. In this experiment, subjects chose which of two buttons to press. Patterns of activation in parietal and prefrontal cortex predicted the choice, with around 60% accuracy, an average of 7 whole seconds prior to the action. The researchers took this to be evidence that the subjective experience of freedom is no more than an illusion.37 However, there seems to be no reason to identify the neural activity predictive of the choice in the experiment with the formation of an intention to act. It may be, instead, a marker of a disposition toward selecting a particular option. It is surprising neither that agents have dispositions toward options that predate their nal decisions, nor that these dispositions are better than chance predictors of their decisions. Daniel Wegners evidence for the epiphenomenality of consciousness is more direct. Wegner assembles a body of evidence, some produced by his laboratory, some by others, for a double dissociation between awareness of acting and actually acting: sometimes agents act without being aware of acting and sometimes they take themselves to be acting when in fact they are not.38 In the so-called I-spy experiment, subjects and a confederate moved a pointer around a computer screen using a mouse, while the subjects listened to a voice naming icons on the screen. If the voiced named an icon just prior to the pointer landing on it, subjects rated the movement intentional even when the confederate had moved the pointer to the icon.39 Thus, under the right conditions, we can have the experience of acting intentionally without actually acting. The opposite dissociation, acting without the experience of acting, occurs in and explains certain kind of psychic phenomena, such as the Victorian pastime of table turning. In table turning, a number of people would sit around a small table, laying their hands palm down on the table surface. The table would sometimes begin to spin, with increasing rapidity. Although participants in this kind of activity may often sincerely deny that they cause the spinning, and may attribute it to paranormal forces, it is not difcult to show that they are causing the movement. The movement of each is small enough to escape detection by them. Thus the double dissociation: we can act while believing that we are not acting (as in
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table turning), and fail to act while believing that we are (as in the I-spy experiment). From the fact of this double dissociation, Wegner moves to a dramatic conclusion: conscious will is an illusion. Wegner explicitly argues that this entails that agents do not have what philosophers understand by free will; he believes that because consciousness is epiphenomenal we are not free. Reconstructing Wegners argument, it runs something like this: 1. free will requires that agents consciously cause their actions; 2. we do not consciously cause our actions; therefore 3. we do not have free will. For reasons we have already glimpsed, however, premise (1) is at best controversial. What role, if any, consciousness must play in the causation of actions for our actions to be free remains subject to debate, but there seems to be no good reason to believe that we must be conscious of the proximate causes of our actions. The fact, if it is a fact, that we are not conscious of these proximate causes does not entail that our conscious deliberation is epiphenomenal; the efcacy of such deliberation might be sufcient to underwrite free will. Furthermore, Wegners evidence falls short of establishing the truth of premise (2). The fact that it is possible to generate a double dissociation between the experience of acting and actually acting does not demonstrate that agents are not reliably aware either of the mental states that cause their actions or even of these mental states as causing their actions. Consider the parallel deduction with regard to visual perception. We na vely think that our visual experiences are extremely reliable guides to actually perceiving things. But in fact there is a double dissociation between having a visual experience and actually perceiving an external object. Sometimes people fail to see the objects in front of them (for instance, when it is dark, their eyes are closed or when they are experiencing temporary blindness) and sometimes people think they are seeing something that is not actually there (when they are hallucinating or subject to a visual illusion of some sort). Should we conclude that our experience of seeing things is not caused by our actually seeing things? Of course not: two things can be very reliably, indeed causally, linked without being exceptionlessly linked. The experience of acting might not be a reliable guide to actually acting, but Wegners evidence does not establish that it is not.40,41 The evidence currently available for the claim that consciousness is epiphenomenal is weak. However, there is emerging evidence from social psychology that seems to suggest that saving a causal role for
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conscious deliberation is not a battle worth winning. In a series of papers, Ap Dijksterhuis and collaborators have accumulated evidence for the claim that when a decision must take into account multiple independent considerations, conscious deliberation lowers its quality. Because consciousness has a limited processing capacity compared with unconscious processes, which can operate in parallel on multiple pieces of information simultaneously, unconscious processes are often more reliable.42 According to Dijksterhuis, this fact entails that when decisions are complex, subjects who are distracted and therefore unable to engage in conscious deliberation prior to making a decision make objectively better decisions,42,43 are more satised with their decisions,44 are less prone to the availability heuristic,45 and more consistent in their judgments.46 Dijksterhuis does not claim that consciousness is epiphenomenal. Rather, he claims that it is causally efcacious, but that its effect is regularly to degrade the quality of our nal decisions. Whereas evidence that conscious deliberation is entirely epiphenomenal would be a major threat to our conception of ourselves, the evidence that conscious deliberation sometimes degrades decision quality might be accommodated. In particular, it is not obvious that there is a threat to free will here, especially given the fact that a number of philosophers have argued on independent grounds that unconsciously generated decisions and actions might be free. Many of these philosophers defend a view according to which agents are morally responsible for actions that express their moral attitudes or practical identities.4750 Nothing in Dijksterhuiss evidence is inconsistent with such a view: indeed, given that one measure that he uses for the superiority of non-conscious processes is postdecisional satisfaction with the choice made, measured against the subjects own esthetic tastes,44 he appears to suggest that such processes produce results more deeply expressive of the agent. However, although some notion of free will can survive, even if Dijksterhuiss claims are true, it seems that we would be forced to revise our notion of freedom somewhat to accommodate these claims. Philosophers appear to have conicting intuitions on the relation between conscious deliberation and moral responsibility. Bernard Williams famously suggested that conscious deliberation might reduce the moral worth of our actions; the man who deliberates before deciding to rescue his wife from drowning has one thought too many.51 Williams thought suggests that our immediate and undeliberative responses might be most fully expressive of our commitments; it is because the man hesitatesthat deliberation is his immediate responsethat we doubt the depth of his
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love. On the other hand, the doctrine of mens rea seems to reect a legal, and therefore probably a folk, commitment to the idea that deliberation regularly makes wrongdoing worse (see Ref 52 for discussion). If Dijksterhuiss view is correct, it seems we will be forced to revise our conception of free action, rejecting those components that emphasize the importance of conscious deliberation. There are, however, good reasons to think that Dijksterhuis cannot be correct in claiming that conscious deliberation lowers the quality of our subsequent decision whenever the decision involves multiple dimensions. There is too much evidence that while non-conscious processing may have a larger capacity, it is limited in how it can process information. In particular, non-conscious processes are less sensitive to logical relations than conscious processes are. Cognitive load manipulationswhich are usually understood as increasing the degree to which behavior is driven by non-conscious attitudesdecrease the degree to which subjects reason in accordance with the norms of logic.53,54 Increasing conscious motivation to be logicalby telling subjects they would need to explain their answersincreases normatively correct responses, while priming the idea of logic appears to activate the motivation to appear logical, but fails to improve performance. In fact, when there was a conict between validity and truth (for instance, when subjects are asked to assess the validity of arguments with obviously false conclusions), increasing unconscious motivation to be logical led to a decline in performance.54 Unconscious information processing seems to be more associative and less rule-based than conscious; hence its relative lack of sensitivity to logical relations. Part of the reason for this difference in how information is processed is the product of the fact that unconscious processes are insensitive to the structure of formal systems, but it is this structure that is essential to rule-based reasoning. Unconscious systems can process semantics but not syntax: even two word phrases cannot be used as primes as a unit. If two words are presented below threshold, each has an independent priming effect.55 Similarly, the unconscious is blind to negation; not p primes p.56 Activating concepts unconsciously has effects on subjects attitudes, but these effects seem associative rather than logical. For instance, activating a stereotype tends to increase the accessibility of concepts related to that stereotype, regardless of whether there is actually a logical connection between the concepts involved and regardless of whether the subject believes there is a connection between the concepts. Thus, for instance, activating the female stereotype might activate concepts like
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helplessness or irrational, regardless of the subjects explicit beliefs about women. There is therefore reason to be skeptical of Dijksterhuiss central claim: we ought to expect less logical organization as a result of unconscious processing, not more. Some researchers suspect that the results are spurious. A meta-analysis of published work replicating Dijksterhuiss paradigm found no convincing statistical evidence of an advantage for unconscious thought.57 However, a rival meta-analysis by members of Dijksterhuiss laboratory is in preparation and purports to nd a signicant advantage of unconscious thought.58 There is reason to think that the apparent conict between the evidence that non-conscious processes are relatively insensitive to logical relations and the evidence from Dijksterhuiss laboratory is a puzzle in need of solution, not dissolution. Part of the explanation for the puzzle may be that conscious deliberation between incompatible options makes subjects more aware of the attractions of each. A keen appreciation of the attractions of the alternatives forgone may increase the salience of the opportunity costs involved in the choice, and thereby decrease post-decision satisfaction. Conscious deliberation may also reduce the opportunities for the mechanisms of cognitive dissonance to work. Cognitive dissonance produced by an awareness of the attractions of forgone opportunities produces a phenomenon described as the spreading of alternatives; the positive qualities of the option chosen are magnied and those of forgone options are depreciated.59 Cognitive load and even amnesia for the choice made does not prevent the spreading of alternatives, indicating that the processes involved are automatic. In fact, there is some evidence that consciousness of the choices made actually reduces the effect.60 If the difference in satisfaction between agents who chose with and without conscious deliberation is explained either by greater awareness of opportunity costs in the former condition, or by greater opportunities for the mechanisms of cognitive dissonance to operate in the latter, or both, there are indeed reasons to think that conscious deliberation has costs, but those costs would not be measurable in terms of the quality of the nal decision as Dijksterhuis thinks. Of course either or both explanations of the results of unconscious thought theory is only partial. A broader explanation may be provided by recent work by Woroquie and colleagues.61 They argue that rather than unconscious thought leading to better decisions, conscious thought may lead to the deterioration of spontaneous judgments. In cases in which subjects failed to form such an immediate judgment, conscious

deliberation brought the expected benets. If this rival explanation of the results is correct, however, we might still be required to revise folk notions of the power of conscious deliberation, since we seem to think not only that non-conscious processes are (typically) not superior to conscious processes, but also that conscious deliberation is (again typically) superior to snap judgment. Further research is required to discover the scope of the alleged negative effect of conscious deliberation on spontaneous judgment. It should be noted that Dijksterhuiss claims concern the power of conscious deliberation, not of consciousness per se. He is explicit that the benets of unconscious processes can be garnered only after conscious encoding of the information.62 Philosophers who have defended the view that expression of our practical identities is sufcient for moral responsibility, but that such expression does not require consciousness, therefore cannot look to his work for vindication of their claims, regardless of how the debate between his view and the rival mentioned above pans out. Both views require too much in the way of conscious processing for these philosophers to nd support on either side. These philosophers rely extensively on thought experiments and ctional cases to advance their case for the limited relevance of consciousness, but there are good reasons to think that these issues are best advanced by attention to the cognitive sciences. The past four decades of work in psychology and, latterly, neuroscience, has given us powerful reasons to think that our intuitions about the powers and limits of the mind often bear little resemblance to reality.

CONCLUSION
As the example just examined indicates, neuroethics in its guise as the neuroscience of ethics shades into what has been called empirical philosophy63 ; philosophy deeply informed by work in the sciences. Neuroethics can also turn experimental, gathering some of the data upon which it reects (e.g., Refs 64 and 65). This kind of overlap is inevitable; disciplines do not have hard and fast boundaries. What distinguishes neuroethics from these other disciplines is that it is more strongly motivated by practical, and especially moral concerns: its work on the mind and on concepts is produced to better inform debates in applied, normative and meta-ethics, as well as debates over what it means to be human. Neuroethics is a very young discipline, but the amount and quality of the material it has already produced suggests that it has a bright future.

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ACKNOWLEDGMENTS
This research is funded by an Australia Research Council Future Fellowship. I wish to thank two anonymous referees for Wiley Interdisciplinary Reviews: Cognitive Science for helpful comments on an earlier draft of this article.

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61. Waroquie L, Marchiori D, Klein O, Cleeremans A. Is it better to think unconsciously or to trust your rst impressions? A reassessment of unconscious thought theory. Soc Psychol Pers Sci 2010, 1:111118. 62. Dijksterhuis A, Nordgren LF. A theory of unconscious thought. Perspect Psychol Sci 2006, 1:95109. 63. Prinz J. Empirical philosophy and experimental philosophy. In: Knobe J, Nichols S, eds. Experimental Philosophy. Oxford: Oxford University Press; 2008, 189208.

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